email from President Charlie Hogan sent to members with email addresses:

The battle to preserve quality affordable health care for both active and retired employees was at the core of the fight for a fair contract that AFSCME members waged over the past 15 months. Never be­fore had Management pushed for such excessive and unaffordable increases. The Employer’s proposal would have increased the average employee health care costs by more than $10,000 over the three-year contract. Costs would have increased by as much as $8,000 a year for many retirees.

The Bargaining Committee succeeded in staving off this massive health care cost-shifting. The Tentative Agreement ensures that state employees and retirees continue to have access to quality, affordable health care.

–      NO requirement that employees and retirees pay a percentage of total costs

Management demanded that the employee and retiree share of the health premiums be determined as a percentage of the overall cost of the health plan, automatically going up each year, rather than the cur­rent practice where the union contract locks in the specific amount to be deducted.

The Bargaining Committee refused to agree to shifting to employee/retiree premiums based on a per­centage of the overall premium cost which would have resulted in employee/retiree premiums uncon­trollably going up—with much sharper increases in each succeeding year.

• NO retroactive employee and retiree health care cost increases

Management demanded that all increases in employee and retiree premiums, co-pays and deductibles be effective July 1, 2012—which would have meant that employees and retirees would have incurred huge retroactive health care contribution costs.

The Bargaining Committee resisted this demand and prevailed: No health care changes will go into effect until July 1, 2013.

–      NO massive increases in premiums. co-pays and deductibles

Management demanded massive increases in employee costs for premiums, co-pays and deductibles. Under Management’s proposals, premiums would have skyrocketed in the first year of the contract, as would most co-pays and deductibles.

The Bargaining Committee fought for more than a year against these excessive increases—and beat them back! Under the Tentative Agreement, the increase in premiums for active employees will be 1% of pay. That 1% of pay will be added to the actual dollar amount currently deducted, and will of course be more than offset by the general pay increase. Dependent premiums will increase but will continue to be a flat dollar amount.

The Committee also succeeded in preventing steep hikes in co-pays and deductibles that would have severely penalized employees or their family members who had the misfortune to suffer serious or chronic illness. The co-pay and deductible rates that the Union achieved take into account the rising costs of health care without placing such an excessive burden on employees or retirees.

Retiree Health

The Bargaining Committee fought to minimize the impact of the newly-enacted Public Act 97-695 (originally SB 1313) by limiting the premium costs that could be imposed on retirees. Under the original CMS implementation plan, many retirees would have paid more than 20% of their pension income for health care premiums. Now retirees will pay only a small fraction of that.

Premiums–Medicare Eligible Retirees

Effective 7-1-13, Medicare Eligible retirees will have 1% of their pension annuity deducted to pay for their share of the health care premium. Effective 7-1-14, an additional 1% will be deducted.

Effective 1-1-14, all Medicare Eligible Retirees will be enrolled in a Medicare Advantage plan that provides a comparable level of services and a comparable range of providers as the current health plans. According to the U.S. Medicare website: A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans.

Medicare Eligible dependents enrolled in a MCHP plan will pay no more than $89.91/month and de­pendents in a QCHP plan will pay no more than $142/month through 6-30-15–the same rates they are currently paying.

Premiums–Pre-65 Non-Medicare Eligible Retirees

Effective 7/1/13, pre-65 Non-Medicare Eligible retirees will be offered a $500/month subsidy if they opt out of the state’s group health insurance plan to be covered in another health insurance plan. Effective 7-1-13, Pre-65 Non-Medicare Eligible retirees will have 2% of their pension annuity deduct­ed to pay for their share of the health care premium. Effective 7-1-14, an additional 2% will be deduct­ed.

QCHP

Effective 7-1-13, premium monthly rates for dependents in the Retiree +1 Dependent plan option will increase $53, from $196 to $249.

Effective 7-1-13, premium monthly rates for dependents in the Retiree +2 or More Dependent plan option will increase $61, from $226 to $287.

MCHP

Effective 7-1-13, premium monthly rates for dependents in the Retiree +1 Dependent plan option will increase $19. The current monthly rate of $94 will increase to $113.

Effective 7-1-13, premium monthly rates for dependents in the Retiree +2 or More Dependent plan option will increase $26.50. The current monthly rate of $132.50 will increase to $159.

Managed Care Healt Plans (MCHP)

MCHP Medical

*Effective 7-1-13, Doctor Office Visits will increase from the current $15 to $18, and effective

7-1-14, the visit will increase to $20.

*Effective 7-1-13, Office Visits to specialists and Home Health Visits will increase from the current

$20 to $25, and effective 7-1-14, the visit will increase to $30.

*Effective 7-1-13, the Emergency Room co-pay will increase from the current $200 to $225, and

effective 7-1-14, the co-pay will increase to $250.

*Effective 7-1-13, the Hospital Inpatient co-pay will increase from $275 to $325, and effective

7-1-14, the co-pay will increase to $350.

*Effective 7-1-13, the Hospital Outpatient co-pay will increase from the current $175 to $225,

and effective 7-1-14, the co-pay will increase to $250.

MCHP Prescription Drugs

*Effective 7-1-13, the prescription deductible will increase from $50 to $75, and effective 7-1-14 the deductible will increase to $100.

*Effective 7/1/13:

• Generic drug co-pays will decrease from $10 to $8.
• Formulary co-pays will increase from $24 to $26.
• Non-formulary co-pays will increase from $48 to $50.

*Effective 7/1/13, the Mail Multiplier for prescription drugs will increase from 2x to 2.5x, resulting in a reduction in the cost savings to employees but still costing less than a purchase at the pharmacy.

Oualitv Care Health Plan (OCHP)

QCHP Medical

*The plan year employee deductible will increase, based on salary, to $350-$500 in FY 14 and to

$375-$525 in FY 15.

*Plan year retiree deductible and dependent deductible each increase from $300 to $350 in FY 14

and to $375 in FY 15.

*In-network, in-patient hospitalization deductible for member and dependent will each increase

from $50 to $100 effective 7/1/14

*Out-of-network, in-patient hospitalization deductible for member and dependent will each

increase from $300 to $500, effective 7/1/14

*Emergency room deductibles increase from $400 to $425 in FY 14 and to $450 in FY 15.

*Co-Insurance In-Network will decrease to 85% effective 7/1/14

*Co-Insurance Out-of-Network will decrease to 60% effective 7/1/13.

*Individual Out-of-Pocket Maximum (In-Network) will increase from $1,200 to $1,500

Effective 7/1/13.

*Family Out-of-Pocket Maximum (In-Network) remains at 2.5x the individual rate.

*Individual Out-of-Pocket Maximum (Out-of-Network) will increase from $4,400 to $6,000

Effective 7/1/13.

*Family Out-of-Pocket Maximum (Out-of-Network) remains 2x the individual Out-of-Network rate.

*Lab/X-Ray In-Network co-insurance will decrease to 85% effective 7-1-14.

*Lab/X-Ray Out-of-Network co-insurance will decrease to 60% effective 7/1/13.

QCHP Prescription Drugs

Effective 7-1-13, the prescription deductible will increase from $75 to $100, and effective 7-1-14 the deductible will increase to $125.

Effective 7/1/13 prescription co-pays will change as follows:

• Generic drugs co-pays will decrease from $11 to $10;
• Formulary co-pays will increase from $26 to $30;
• Non-formulary co-pays will increase from $52 to $60.

The Mail Multiplier for a 90-day supply of prescription drugs will increase from 2x the 30-day rate to 2.5x the 30-day rate, resulting in a reduction in the cost savings but still costing less than the pharmacy rate.

Vision

Effective 7/1/14, new lenses will be covered on an annual basis.

Effective 7-1-13, the co-pay for Vision Eye Exams, Vision Lenses, and Vision Standard Frames will increase from $10 to $20. Effective 7-1-14, the co-pays will increase from $20 to $25.

ilsinglepayer.org

What Expanded and Improved Medicare for All Would Mean for Organized

Labor

Health insurance is off the bargaining table because everybody, including spouses and children, has it

Better benefits: all necessary medical care covered under one plan

Lower cost: no premiums, deductibles, co-pays, insurance, or non-covered services; most people would pay less

Progressive financing: those who have more pay more, those who have less pay less

Money used to purchase health care instead of going to administrative overhead including insurance company profits and executive compensation

Complete choice of providers

No insurance company interference between patients and doctors Portable throughout the United States

No interruptions in coverage for periods of lay-off or other unemployment, no matter how lengthy, including job loss

Need for health insurance not a barrier to changing jobs or careers

Need for health insurance not a barrier to early retirement, or to opening one’s own business or becoming a full-time volunteer; so jobs freed up for younger people

No tax penalties for having good health insurance

No treatment delays while workers comp and regular insurance fight to avoid responsibility

Cost of health insurance not an incentive to employers to reduce hours or shift to temp workers to avoid paying for health insurance

No change in benefits or providers at retirement

Employers save all the costs associated with administrating health insurance

Gets rid of the competitive disadvantage for employers who offer health insurance compared to those who don’t

No one with a contagious disease unable to get care No one goes bankrupt over medical bills

Patients and families don’t waste time fighting with insurance companies; anxiety over medical bills doesn’t interfere with recovery

Improved general population health

Enhanced social solidarity: we are all in the same system instead of being pitted against each other; we all have an incentive to fight for a high quality system

Problems with Obamacare for organized labor

Incentives to employers to stop offering health insurance, reduce hours, and switch to temp workers

Some workers, especially low wage workers especially may suffer “chum,” that is, shift between eligibility for Medicaid and eligibility for subsidies on the exchanges

Tax on plans that offer better coverage, falsely called “Cadillac plans”

No cost controls, so total health care costs will continue to rise, and those costs will be paid by workers

Threats to multi-employer plans (Taft-Hartley plans) include adverse selection, that is. Loss of younger workers as employers drop insurance

So-called “wellness programs” penalize lower wage workers and minorities, who have greater risks of poor health, and sick people in general

Those who have relatively good insurance pitted against those who have poor insurance or none

The Medicaid expansion will be used by the health insurance industry to further Medicaid privatization—forcing recipients into for-profit HMOs; this will set the stage for further privatization of more and more public services

Gives more money and power to the health insurance industry, which will use them to further tilt the playing field toward its own interests and against the interests of the people

Unaffordable under-insurance becomes the standard that pulls everybody down

What we need: Medicare for all, for life.

Everybody in, nobody out.              One nation one health plan.

Compiled by Anne Scheetz MD, annescheetz@gmail.com for ISPC, March 2013. Printed in-house with donated labor.