Workers push back on insurance changes, but majority says plan will keep program stable

Kathy and Bob Morris, retired school teachers from Cabell County, arrived at the state Capitol early on Saturday to talk to lawmakers about their concerns over proposed changes to West Virginia’s insurance program for public employees.

They sat in the gallery above the chamber as delegates debated the changes for more than three hours and finally passed the insurance bill.

So the Morrises were frustrated and disappointed.

“I just feel like some people you talk to, it goes in one ear and out the other — and they keep telling me, this is what we’re going to do. It doesn’t make any sense.”

Supporters of the bill in the Republican majority said the financial moves are necessary to keep the Public Employees Insurance Agency solvent.

Officials sounded alarm prior to the session after Wheeling Hospital announced it would move away from taking PEIA because of low reimbursement rates. The strong worry is that other medical providers would follow. The bill increases the reimbursement rate for providers to 100 percent of what Medicaid pays, easing that issue for now.

On costs to employees, on of the bill’s main thrusts is to return a cost-sharing ratio to 80-20 between the government and employees, a snap back that labor organizations contend will result in sticker shock. That premium increase, leaders said, could be as much as 26 percent.

Another scrutinized aspect of the bill would eliminate an opt-in for spouses and institute a buy-in instead. That’s an estimated $147 a month.

State leaders said the additional costs could be offset by a $2,300 across-the-board pay increase along with broad tax cuts.

The Morrises were left shaking their heads. They are accustomed to push-backs at the Capitol, participants in the 11-day 1990 teachers strike over pay levels and the 12-day teachers strike in 2018 over pay and out-of-pocket insurance costs. They wished more public employees had joined them this Saturday morning.

“I just feel like every time we come here, it’s just like they’re telling us ‘This is what we need to do to shore up the state. Sorry we’re putting it on your backs,” Kathy Morris said outside the door to the House of Delegates chamber. “I don’t know. I just feel like people are getting really stooped over from the weight they’re carrying.”

Their daughter, they said, left a more lucrative corporate job to become a teacher. “I look at the huge pay cut she took already and the fact that her small salary is going to get exponentially smaller by the shenanigans they’re doing with PEIA now — I had to be here today. I wish there was a huge delegation.”

Kathy Morris, who taught special education classes over more than 25 years, expressed worry over the number of teachers in classroom and whether the insurance changes would discourage recruitment.

“The position that I left has been posted 14 or 15 times because they can’t find a qualified teacher to fill it,” she said. “Every day that I sub, I have to cover classes on my planning period because there are not teachers to cover classes. There are not teachers to fill classes.

“And they think these changes to PEIA are going to attract more? Our deficit is going to grow. Young teachers are going to be like, I’ve got to go back to working in corporate America because I can’t survive.”

Debate on the House floor covered many of the same themes, with delegates discussing the financial strain of the program up against the effects on employees.

“There’s an understanding, an implied contract that, ‘Hey, we might not be able to pay you the best but guess what we’re going to give you some really good health insurance,’” said Delegate John Williams, D-Monongalia.

Delegate Todd Kirby, R-Raleigh, said West Virginia teachers are paid far less than counterparts in surrounding states.

“They were promised that if you stayed here, you and your family would have insurance that was reasonable and good and the state would back you up and take care of you,” he said.

In the end, the vote was 69-27.

House Speaker Roger Hanshaw spoke to reporters outside the chamber, explaining the balance that delegates had to consider. He said the need to shore up the program was the heaviest factor, and that action now increases the likelihood of solvency over the long term.

“It’s one of the biggest goals we set out to achieve, to make sure this program, one of the primary benefits to our state workers, is solvent and secure and healthy going into the future,” said Hanshaw, R-Clay.

Hanshaw, now an attorney in private practice, noted that he is also a former state worker whose primary insurance was PEIA. “I have been on PEIA in two different state jobs in the past, so I know the importance of that program. I know the importance of that benefit because I received it,” he said.

“And I also know that if I took my PEIA insurance card to a physician or a pharmacy or to someone who provided me with a medical benefit and that card wasn’t honored then that benefit is meaningless. So our objective is to make sure our employee benefit is an actual benefit.”

Delegate Matthew Rohrbach, the deputy speaker, did much of the speaking in defense of the bill during the marathon floor session. His first remarks highlighted PEIA’s current $154 million deficit and projections that by 2027 the program could be $424 million in the red.

In his final argument for the bill, Rohrbach provided the context of the many times he has sided with public educators to support pay raises and against initiatives that he had concluded could erode public school systems.

But this time, Rohrbach said, he had to support the insurance changes because he wants the program to be stable for years to come.

“We have to act,” Rohrbach, R-Cabell, said outside the House chamber. “Failure to act is going to put us in such a hole three or four years from now  that everybody’s going to be even more upset then when their plan is worth nothing, they can’t be seen. Have we really given a benefit if we’ve given a card that nobody will take? We have to stabilize this plan.”

Rohrbach, a physician, reflected on the Wheeling Hospital announcement just prior to the session’s start that it would soon stop taking PEIA. That made lawmakers across the state wonder if their local hospitals might be next.

“There’s no question it was that close,” Rohrbach said. “There are a number of doctors not taking it already. One major pharmaceutical chain has stopped taking our employees’ prescriptions. We simply had to do something.”