Improving New Jersey’s Health Benefit Reform
♫ Thursday, June 2nd, 2011In New Jersey, there is broad agreement that public employees should pay more of their health insurance premiums. Governor Chris Christie (R) wants all state and local workers to pay 30 percent of their insurance premiums. Senate President Steve Sweeney (D) wants to put contributions on a sliding scale, with low income workers paying 12 percent and those making over $100,000 paying 30 percent. Even the Communications Workers of America, the union representing many state employees, has proposed a plan where workers would pay on average about 13.5 percent of their health premiums.
Any of these proposals would be an improvement over the status quo (now, most workers pay 1.5 percent of salary toward their health benefits, which works out on average to about 8 percent of the premium). But the debate over what percentage of insurance premiums employees should pay somewhat misses the mark. If public workers get overly generous health benefit packages, the objective should be to reduce the employer’s contribution toward health benefits. One way to do that is to raise the employee contribution. But there is also another way — reducing the total size of the health benefit, by moving public workers away from costly “Cadillac” health plans.
The requirement that most workers pay 1.5 percent of salary toward health premiums was only enacted in 2010; previously, many public employees in the New Jersey made no contribution at all toward health premiums. Even after the 2010 reform, public workers still pay much less toward their insurance than is typical in the private sector: private employees in the state are typically responsible to cover 21 percent of their premiums for single coverage, and 23 percent for family coverage.
It is also important to note that public employees’ payments do not vary with the cost of coverage. It is common for a private employer to offer multiple health plan options, with a higher employee share of premium for a more generous plan. This encourages employees to take less fancy plans and therefore holds down health care costs. And because state workers do not have to pay extra to put their spouses and children on their plans, public workers who are married to private workers are highly likely to use government insurance for the entire family.
Either the Christie or the Sweeney plan would do a great deal to address these problems: employee contributions toward health insurance would go up, and they would be linked to the premium for the plan covering the employee. Employees who choose to take up coverage for their whole families will pay extra for that privilege. And employees could be offered high – and low-cost health plan options, with some savings accruing to them if they pick less generous plans. Even the CWA plan would be a modest improvement in these regards.
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