Missouri switching to deductibles for health plan

Sunday, July 25, 2010

JEFFERSON CITY, Mo. -- Missouri employees and retirees soon may have to pay more out of their pockets for health care -- a result of state budget troubles that also have led to frozen wages and pension changes.

The board of the Missouri Consolidated Health Care Plan approved changes last week that will switch people from a copay to a deductible model for their health insurance, beginning Jan. 1.

About 100,000 state employees, retirees and their families are covered under the health plans.

Most participants now have co-payment plans in which they pay a flat amount -- such as $25 for a doctor's visit or $100 for an emergency room visit -- and the state health care plan picks up the rest.

But that option will end, and participants will have to choose one of several deductible insurance plans.

Under one option, employees would have to cover their first $600 of medical bills each year, then would be responsible for 10 percent of their additional medical costs until they reach a maximum total out-of-pocket expense of $1,500, after which the state plan would cover the rest.

Under another option, employees willing to pay higher monthly premiums could have a deductible of $300 and a maximum out-of-pocket expense of $1,200.

Richard Bowles, the executive director of the Missouri Consolidated Health Care Plan, said changes had to be made because the state could no longer afford the current health plans.

"It's a matter of how much money the state has to subsidize the health care," Bowles told the Jefferson City News Tribune. "Right now, the state has less money -- the tax revenues are down. Everything's down."

The Missouri Consolidated Health Care Plan received $435 million from the state during the 2010 fiscal year that ended June 30, state budget director Linda Luebbering said.

The agency had requested a budget increase to $446 million for the 2011 budget that began July 1. But lawmakers instead cut its budget to $420 million, Luebbering said.

That reduction forced the governing board for the health care plans to make changes to its insurance options.

Luebbering told The Associated Press that in order to meet the budget cuts, the state health plans also will rely more on generic or less-expensive prescription drugs, eliminate coverage for stomach reductions and fertility treatments and charge families more money for covering multiple children.

The board's approval of the health plan changes came barely a week after legislators approved changes to the state's pension system.

Employees hired starting in 2011 will have to contribute 4 percent of their pay into the retirement system. Currently, state workers do not pay anything into their pensions, and the retirement system is funded by taxpayers and investment income.

To qualify for their pensions, employees will be required to spend a decade working for the state instead of the current five years. The minimum retirement age will be increased from 62 years old to 67 years old for most employees.

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