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March 10, 2010

Spin on the Health Panel

Justin Katz

Rep. Joseph McNamara (D, Pawtucket) — himself the Alternative Learning Program Director for the Pawtucket School Department — recently published an op-ed defending legislation that he submitted (and which passed) that created a healthcare panel to design insurance benefits for all of Rhode Island teachers. (The legislation, incidentally, inspired the introduction of our legislative stooge list.) The intention of his essay is to lull Rhode Islanders back to sleep, on this matter, but he shouldn't succeed.

Most centrally, his argument cites internally incompatible benefits to the legislation. First:

... the Department of Education studied the issue and found that combined purchasing of health benefits for education employees could save up to $15 million a year.

Yet, second:

... the legislation provides that "choice of benefit plan designs, medical insurance cost-sharing, payment for waiving medical insurance, eligibility for receiving benefits and providing benefits for retirees shall continue to be negotiated" by the districts.

If districts remain able to choose different programs from different insurers, then the maximum savings cited by McNamara cannot be achieved. In other words, the law can only function by limiting school districts' options. Indeed, that is its plain purpose. Note this sly admission that the law amounts to another unfunded mandate:

... it includes the requirement that the value of at least one of the plan designs "shall not be greater than the lowest" plan in effect today.

I don't have the time, just now, to sort through every district's actuarial report, but general familiarity with the issue is enough to suggest that the "lowest plan" is hardly a discount program. If there were such a plan currently in effect, McNamara would surely have cited it as evidence; that he doesn't offer any details for this claim suggests that vagueness suits his political purposes. Essentially, the legislation ensures that the now-mandated health insurance benefits will never decrease, except perhaps minimally with inflation. As for districts' ability negotiate cost-sharing and so forth, here's the actual language (PDF):

Choice of benefit plan designs from those approved in accordance with section medical insurance cost-sharing, payment for waiving medical insurance, eligibility for receiving benefits, and providing benefits for retirees shall continue to be negotiated pursuant to sections 28-9-3 and 28-9-4.

28-9-3 and 28-9-4 do not lay out rights to negotiate certain parts of a contract. Rather, they deal with arbitration. I'm open to correction from legal experts, on this, but defending how one takes the phrase "pursuant to," it would be plausible to argue that the only way to reduce healthcare costs within McNamara's legislation would be through arbitration.

It's a simple matter of reasoning: During a time of growing dissatisfaction with the imbalanced remuneration of public-sector employees, one such employee introduced legislation mandating health insurance benefits with heavy influence from the relevant unions. Keep your eye on that ball; the rest is just fancy footwork.

(Of course, since the legislation passed, attentiveness must be to having it repealed and removing all .)