CAPITOL BEAT: Lawmakers take steps to address PEIA solvency

CAPITOL BEAT: Lawmakers take steps to address PEIA solvency
Published: Mar. 7, 2023 at 7:11 PM EST
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CHARLESTON, W.Va. (WVVA) - Employees on the state’s public health insurance, also known as PEIA, may see an increase in their premiums.

Faced with numerous medical providers pulling out of participation due to low reimbursement rates, some lawmakers argued the increases were necessary to ensure the program’s future solvency.

The bill that passed the Senate on Monday would provide for a 110 percent reimbursement on the current Medicare rate to providers. To help pay for that, the legislation mandates an 80-20 split in insurance costs split between employers and employees -- a move that could result in an increase in premiums.

The measure also includes a provision that would help ensure an employee/employer match at 70-30 percent for out-of-state medical care for non-contiguous out-of-state counties.

West Virginia Education Association President Dale Lee said he would have liked to have seen the state take steps to ensure solvency. “To have to go back and pay for these three years with no increase to putting money in the reserve, it just wasn’t the right thing to do to employees.”

Delegate Todd Kirby, (R) Raleigh County, opposed the bill, saying he would like to see the state take a more long-term look at addressing the problem, including the rising costs of medical care.

“I think there’s absolutely a way to fix this. We sent 290 million dollars to Weirton to build a battery factory on technology that has not been proven. We could have taken a fraction of that and at least had a short-term fix to PEIA to have stakeholders sit down at the table and have common sense solutions that didn’t cause a jolt to family budgets.”

The measure includes a provision for spouses who are eligible for employer-sponsored health care. If the bill is signed into law, spouses will have to buy into the program at a rate of $147 a month. Spouses who do not have an insurance option will still be able to participate.

“Adding the spouse provision on there is a big burden to some individuals who have a spouse in the family,” added Del. Christopher Toney, (R) Raleigh County.

Sen. Rollan Roberts, (R) Raleigh County, said that while the bill is not perfect, it is necessary to ensure the insurance’s future solvency. He also pointed out that the state gave workers a more than two percent raise to offset the costs. He said that, combined with the income tax cut, should help those taxpayers come out ahead.

“We got handed a difficult situation. We have to work through the problems, everybody knows something has needed to be done for some time, and finally we’re able to work somethings out that will salvage PEIA.”

If the Governor signs the legislation into law, most of the provisions of the bill would take effect on July 1, 2023.