The State’s Employee Health Benefits Mess

Like all fifty states, North Carolina provides health care benefits for its state employees. Unlike other states, North Carolina paid for 100 percent of the monthly premium costs for a basic or “standard” health plan for individual employees plans in 2009, and was one of only seven states at that same time that paid for 100 percent of the “defined standard” monthly premium costs for at least some employees families.

Eligibility, amount of coverage, and employee share of costs vary greatly from state to state. However, it is quite obvious that North Carolina has one of the most generous packages in the entire US. Although this is beneficial to state employees, the costs are a great drain on state resources.

With rapidly increasing premiums, recession-related budget shortfalls and increases in co-payments and deductibles, it may be time for North Carolina to explore spreading some portion of costs to state employees.

Based on a 2010 study, a growing number of states are implementing a 40 percent-or-more cost sharing category with many plans reporting deductibles greater than $500 per-person. These per-person deductibles are getting progressively closer to the premiums that would be paid even if the individuals and families had other insurance.

Therefore, as North Carolina looks to rein in state expenditures and as there continues to be political debate over state employee health care benefits, perhaps there should be more focus on how to improve cost-sharing and health care access than on vetoes and overrides.

Nicole Fisher

Nicole Fisher is a current PhD candidate at the University of North Carolina in the Health Policy and Management Department. She also currently writes health care policy for t...

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