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Generous Health Plans Strangle Massachusetts Cities, Towns

Posted by Eileen McAnneny on Apr 5, 2011 10:06:00 AM

Financially strapped cities and towns in Massachusetts spend 37 percent more to provide health insurance to their employees than the amount spent by private companies as measured by the AIM Benefits Survey, according to a report released this morning.

Municipal Health InsuranceThe report by The Boston Foundation and the Massachusetts Taxpayers Foundation, entitled Municipal Health Plans: Gilded Benefits from a Bygone Era, concludes that municipalities face a deepening financial crisis because of generous health insurance benefits under which employees pay minimal co-payments or deductibles. The result: some cities and towns face significant layoffs because they must use more than 20 percent of their budgets to buy health insurance for employees and retirees.

The study urges state lawmakers to support moves to allow municipal officials to negotiate health insurance plan design outside of collective bargaining. AIM has filed a bill that would permit those negotiations, while Governor Deval Patrick and other have filed slightly different reform proposals.

“Employers care about municipal health care costs because the more money that cities and towns must spend on health premiums, the less they spend on schools, public safety, roads, bridges and other services that impact the Massachusetts economy,” said John Regan, Executive Vice President of Government Affairs at AIM.

The new report compares health insurance benefits in 14 Massachusetts municipalities with two plans offered to state employees, the Federal Employees Health Benefit Plan and statistics on private coverage taken from the 2010 AIM Benefits report, Trends and Practices Among Massachusetts Employers. Among the comparisons:

  • The average municipal family plan premium of $20,925 is $5,600 higher (37 percent) than the average private sector family premium, 33 percent more than the federal plan premium, and 21 percent more than the state’s Group Insurance Commission plans.

  •  In the municipal plans, the average co-payment for a visit to a primary care physician (PCP) is $11. State, federal, and private sector employees on average pay almost twice as much for visits to a primary care physician. Specialist visits averaged $14 for municipal workers, while the co-pays were a minimum of $20 in the GIC plans, $30 for federal workers, and averaged $20 for private sector HMO plans.

  • Municipal employees pay less for generic prescriptions than other employees.

  • Nine of the 14 communities had no co-pays for most other medical services, including high-tech imaging, outpatient surgery, and inpatient hospitalization. The other five communities have no co-payments for high-tech imaging but have co-payments averaging $128 and $228 for outpatient surgery and inpatient hospitalization. State, federal, and private sector workers pay at least $75 for high-tech imaging, $150 for outpatient surgery, and $250 for an inpatient hospitalization.

  • No municipal plan studied includes a deductible. In the other public and private plans, members are responsible for a minimum deductible of $250 for individuals and $700 for families.

Topics: Municipal Reform, Health Care Costs, Health Insurance

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