Dale Folwell is not a "friend" of state employees


Friends don't try to get your children booted off your health insurance:

Since he took office in 2017, Folwell has repeatedly advanced or acquiesced to policies that would ultimately reduce the number of people on the SHP rolls. In May of 2017, for example, state employees received an email and letter sent via “junk mail” rate postage instructing them to resubmit a copy of the first page of their tax returns, or children’s birth certificates in order to prove they are not fraudulently covering spouses or dependents under the SHP.

After receiving the letter, I for one thought that it was a scam since it had all the telltale signs, and I had already recently submitted my tax return to prove that my children are my children, and are eligible to be covered on my plan. Folwell’s letter said I had to submit copies of their birth certificates by July 31 through an online portal, or my children would be removed from my health insurance plan on August 1. Six hundred people were removed from the SHP for the rest of 2017. Of that number, how many were actually fraudulent?

In a sane world, the employees' union would have pushed back on that, and made sure that nobody (or their children) fell through the cracks. But "sane" and "SEANC" probably shouldn't be used in the same sentence. Tweets I saw back then were completely supportive of Folwell's "fraud" claims, and SEANC's website itself published Folwell's entire statement with no comments or rebuttal:

The audit is being conducted to ensure that those dependents on the plan, are actually eligible to participate. This is not only a legal requirement, but part of an effort to reduce waste, fraud and abuse. With healthcare and drug prices continuing to rise, the plan must address cost concerns in order to provide quality coverage at a reasonable rate without constantly adjusting deductibles and copays. The plan not only wants you to have benefits, but to be able to afford to use it.

This audit addresses several important issues: Every dollar spent on someone receiving plan coverage who is ineligible is money out of the plan’s pocket. The state has an unfunded healthcare liability of about $42 billion. Any unnecessary expenditures from ineligible dependents adds to that liability. Ineligible individuals using plan coverage threaten affordable copays and deductibles and increases unnecessary spending. Freezing family premiums so younger state employees and their families can afford coverage. Right now, a starting teacher, trooper or firefighter must work five days out of every month to afford family coverage.

A lot of that is either hyperbole or outright misinformation, but the entity who should have called him out (SEANC) just went ahead and played along. Just like it's doing now with the "clear pricing plan," which is about to blow up in Folwell's face. Back to the OP:

Health care providers originally had to sign on to the Clear Pricing Project by July 1 or risk becoming out-of-network providers. As of July 22, fewer than half of providers and only three hospitals and had signed on. Instead of digesting his plan’s impact on state employees, Folwell has doubled down on his failed plan and re-opened the window by extending the deadline to August 5.

State employees and retirees have been noticing signs popping up at their doctors’ offices indicating that they will not sign on to the new terms and will therefore no longer be in-network providers as of January 1, 2020. For an employee on the standard 70/30 plan, their deductible obligation would double when using out-of-network providers, and $40 office visit copays would become 50% payment after the deductible is met.

In April, the House passed a measure to delay implementation (HB 184), but thus far Senator Phil Berger has refused to allow the Senate to discuss this bill on the floor, and it remains stuck in a committee, regardless of the negative impact this plan will have on state employee health care. Failure to conclude a resolution to the Clear Pricing Project by October will clearly leave state employees in a lurch – a situation in which they may be forced to shop around for other insurance programs for themselves, spouses, or dependents in the face of health plan uncertainty or increased out-of-pocket costs.

But given past experience, one can’t help but wonder whether Folwell might actually welcome such a development. After all, making the SHP unattractive to employees and their dependents, and forcing people to leave the plan would clearly be an effective cost-cutting measure. The same is true for making out-of-pocket health care more expensive (and thereby reducing the amount of care sought).

That last part sounds kind of conspiracy-theorish, but honestly, we've seen Republicans do this time and time again: Tear something down and then call it broken. Look at the Affordable Care Act. The R's knew if they blocked Medicaid expansion, the unfunded gap would drive up premiums for the rest, and it did.

I'll leave you with SEANC lamely trying to rebut the OP:

Somebody in this equation is blind alright...