Teachers and state workers are feeling the strain as their health benefits, once a reliable perk, seem to be slipping away. New State Treasurer Brad Briner recently raised concerns about rising health care costs. He warned that increased premiums could hit the State Health Plan by 2026.
This week, Briner’s office announced a meeting to discuss introducing salary-based premiums. This means higher earners would pay more for health coverage. Many employees are already dealing with increased out-of-pocket costs after the State Health Plan switched from Blue Cross Blue Shield to Aetna this year. For example, one teacher reported her copay for specialist visits jumped from $40 to $80. Social media threads are filled with complaints about rising costs for various services, including physical therapy and mental health support.
Amanda Thompson, president of the Charlotte-Mecklenburg Association of Educators, noted that many teachers were not prepared for these increases, as they were informed that few changes would occur with Aetna. She expressed concern that teaching staff already struggle to keep up with inflation impacts on their salaries.
The State Health Plan covers around 750,000 people in North Carolina, roughly 8% of those insured in the state. Like private plans, it is grappling with soaring health care expenses. Recently, Forbes ranked North Carolina as the most expensive state for health care. This caught the attention of lawmakers as residents face crippling costs, with many feeling the need to delay medical appointments or skip necessary tests to save money.
Feedback from teachers across the state shows discontent with the transition to Aetna, with Bryan Proffitt from the North Carolina Association of Educators receiving numerous negative comments in just hours. Many are shocked to find that what was once affordable is now much pricier.
The rising copays are partially due to fewer providers participating in the Clear Pricing Project, designed to keep costs manageable for state employees. The State Health Plan also faces a daunting projected deficit—$507 million in 2026, potentially reaching $1.4 billion by 2027. The board is expected to discuss strategies to address this financial shortfall in their upcoming meeting.
Briner has indicated that tough decisions are on the table. Discussions could lead to changes in premium structures and possibly cuts to retiree benefits. Ardis Watkins, from the State Employees Association of North Carolina, proposed that instead of only raising premiums, there should be more transparency regarding the costs paid to health care providers, noting that some hospitals charge exorbitant fees hidden by secrecy laws.
Watkins argued that public awareness of these charges could stimulate more competitive pricing. Briner agrees on the need for transparency but emphasizes the importance of collaboration among all stakeholders to create a better health care environment in North Carolina.
The struggle for reasonable health care costs is further compounded by the growth of large hospital systems, which have strong negotiating power. These entities can command higher fees and complicate affordability efforts. Other states are experimenting with cost-control measures, like price caps, which North Carolina has so far resisted.
Following the switch to Aetna, many providers opted not to join the Clear Pricing Project, leaving some employees without the previously available options. The State Health Plan is now reassessing its contract with Aetna, as they navigate costs while trying to maintain sufficient provider participation.
Despite previous efforts to enforce the Clear Pricing Project, Briner admitted the optional nature of the program did not yield the savings hoped for. Proffitt believes that rather than shifting the burden to public employees and educators, the state should explore other avenues to resolve budget issues.
As the conversation about health benefits continues, many are left wondering about the future of their coverage and the financial pressures they face every day.
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