My heart went pitty pat when I saw this email in my inbox yesterday at 4:35 p.m. almost as much as with this morning’s earthquake:
Re: Educate Oklahoma
Dave Bond <dave@ocpaimpact.com>
Sep 2 at 4:35 PM
To Gary Watts
Gary, my apologies for the delayed response. The finishing touches are being put on a summary of the reform, which we should be able to forward to you next week. The reform was passed during the 2015 legislative session at the state Capitol as House Bill 1567. Principal authors were Rep. Glen Mulready, of Tulsa, and Sen. Greg Treat, of Oklahoma City.
Thank you for reaching out to us. Will forward that more expanded summary to your soon.
All the best,
Dave
Dave Bond
OCPA Impact, Inc.
405.684.0563 mobile
dave@ocpaimpact.com
This summer Linda and I watched (for me probably the 20th time) my favorite musical “The Music Man” with our grandchildren (for them the first time). Now our grandson is beginning trombone instruction in the 6th grade (so happy the arts haven’t been eliminated in their district) and knows the source of the most iconic song about that instrument. My favorite has always been the part when little Ron Howard and the rest of River City are awaiting the Wells Fargo Wagon as he anticipates “something special just for me”. That will be my emotion this lovely Labor Day weekend as I anxiously await Dave’s explanation of the $100 million he assured Channel Six viewers last week on “Educate Oklahoma” is available for teacher pay raises.
Here is House Bill 1567: HB1567 ENR
which makes this change only:
The Health Insurance Plan may provide for the application of deductibles and copayment or coinsurance provisions, when equally applied to all covered charges for services and procedures that can be provided by any practitioner for the diagnosis and treatment of a particular illness, disease, injury or condition unless deductibles, copayments or coinsurance variations that are based on contracts with providers for specific services based on levels of outcomes or cost.
Therefore, by deleting 37 words and adding back only 3 (can’t get them underlined so bold italic) we will have $100 million available for teacher raises. Don’t you love lawyers. I hope it is true but having spent some time learning about our state and education employees health insurance plan I am skeptical. So what better way to spend part of Labor Day weekend than writing about health insurance, one of the many benefits American workers enjoy due to the labor union movement in this country.
First let’s put the $100 million to be available into perspective. In April of 2013 our statewide large school district CFO group (MABM) met with officials of Oklahoma’s Employee Group Insurance Division of OMES to learn and have dialogue about the impending implementation of the Affordable Care Act. Here is a link to their presentation that day. EGID.04042013-rotated (by the way rotatepdf.net works) Looking at their website the most recent annual report available is for calendar/plan year 2014 so this 2013 presentation about as up to date as I can easily access. Look at page 2 and you see that it was a $917 million operation then so surely is somewhat over $1 billion by now. Notice also on page 5 that this is the program for education employees as well as state workers, including their families and many retirees, in Oklahoma, about 220,000 that year.
So what Dave Bond/OCPA told Oklahomans last week is that replacing those 37 words with 3 new ones will reduce about $1 billion to just about $900 million, about a 10% savings. Though I’m skeptical, I will be delighted if it is true. One reason I’m skeptical is shown in this table that I put together using the information I gathered from Sand Springs Public Schools records for the monthly premium cost of this insurance (calendar plan years) since 2003. FBA Premium History
HB 1567 was signed into law on April 13, 2015 and became effective November 1, 2015; during that year the insurance premium for employees was $499.42 and a premium increase to $515.82 for 2016 was established some time that summer even after EGID knew about HB 1567. Following the same timing this year the premium for 2017 has been set at $571.04 and is part of every state agency and school district budget for FY 2017. This increase comes more than a year after the passage of HB 1567 and unfortunately is about the same $100 million except up instead of down.
It appears from the language, and here I’m really making a poorly educated guess, that what HB 1567 will allow EGID to do is to have different deductibles and coinsurance rates within its plans for different procedures and providers. I don’t live in their world and certainly want the plan to be able to negotiate favorable costs for state and education employees because that is one of the huge benefits of having health insurance, but I just have to be skeptical that there is $100 million savings available so soon after their cost analysis moved premiums by about the same amount upward. This is why I am awaiting “something special” from Dave Bond and the OCPA.
A couple of final words. Please look carefully at the Premium History chart I put together. The OCPA will predictably blame every adverse occurrence in the health insurance world on Obamacare — the Affordable Care Act. As you can see from the chart the pre-ACA premium experience was worse than the post-ACA premium experience (ACA approved 2009 and gradually implemented thereafter with the personal mandate in place for 2015 I think). We’ve had challenges with health care cost increases in this country for decades and the reasons are many and complex. Whether ACA has helped or hurt is a fair question, but if we ask the thousands of Oklahomans who now can get insurance that was previously denied to them they will say it has helped. And if we ask the states that had the wisdom to accept the Medicaid dollars which Oklahoma foolishly turned down, they have been helped as well.
What is interesting though is that the ACA/Medicaid debate may be a barely relevant sideshow to the real drivers of medical cost increases. Take a look at this Time Magazine article for an eye opening look at the “free market” that is health care in the United States. 2013,2,26,MedicalCostsDemandAndGreed More later about the “free market” in health care.
A week later, 9/10/2016 and nothing new received or noticed.
Please note that I have switched the photo from the “Waiting For Dave Bond” post to this one as a hint for its location; and the new photo on that post should be easy for someone out there. Lunch on me and this weekend thank a union member for your health insurance.
2 thoughts on “Something Special”