By Julia James | Mississippi Today

Athena Lindsey, a teacher and policy fellow with Teach Plus Mississippi, repeatedly heard the same concern when surveying teachers in the lead-up to the historic 2022 teacher pay raise: “Every time you see a pay increase, the insurance premiums always go up, so you never really get to feel the actual pay raise.”

Insurance premiums for public employees rose 6% on Jan. 1 of this year, the fifth consecutive year with an increase. The report of the Teach Plus Mississippi survey showed lower insurance premiums as the third highest policy priority for teachers, behind two related to pay increases.

“A lot of them in the survey said that they had second jobs just for that reason because the insurance plans were ridiculous,” said Lindsey.

The average teacher salary in Mississippi is $53,000, which drops to $40,990 after taxes and retirement contributions, according to calculations by Mississippi First. Premiums for individuals on the plan make up 1% of their take-home pay, but 25% for employees with their family on the state insurance.  After premiums, take-home pay for employees with their families on the plan drops to $30,910.

Five teachers interviewed by Mississippi Today expressed growing frustration with the rising costs and falling benefit quality. State officials say these changes were made to counter rising health insurance costs that are causing financial deficits, with the reserves of the state plan dropping $119 million over the past nine years. Legislators say they are looking to address this problem next session.

The state health plan served nearly 194,000 state employees and their dependents in 2021, the most recent year for which there is data. Most people opt for the “Select” plan with more benefits, but the number of people on that plan has been slowly falling since 2016.

Premium costs have remained largely unchanged for individuals on the single-employee plan, but people whose families also receive insurance through the state plan have seen more significant increases.

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Per state law, the state contributes 100% of the premium cost for basic coverage for employees. Employees pay between $20-46 monthly for individual coverage if they opt for the plan with more benefits. The state does not contribute to premium costs for children and spouses, making family coverage significantly more expensive. Prices range between $124 and $840 a month and vary based on the number of dependents and quality of coverage.

Mississippi is one of two states in the Southeast that doesn’t pay any extra towards premiums for family coverage, according to figures compiled by the Mississippi Department of Finance and Administration that were presented at a 2021 hearing. Rep. Kent McCarty, R-Hattiesburg, introduced a bill this session for the state to pay 50% of dependent premiums, but it died in committee.

“A lot of jobs are offering coverage for dependents already, and a lot of times teachers leave to take those jobs, so we thought this could be a way to make the teaching profession more competitive with others and keep teachers in the classroom,” he said.

A recent report published by Mississippi First studied why teachers are leaving the classroom. In it’s survey, 42% said they could not afford deductibles, premiums, or other health care costs not covered by insurance, and financial insecurity was closely linked with risk of leaving the classroom.

“Any improvement in this area, whether that is reducing cost for teachers or improving the quality of the plan, is all going to necessitate more resources from the state,” said Toren Ballard, K-12 policy director for Mississippi First.

This gap between individual and family premiums is common in the teaching profession. According to a 2020 report published by the Southern Regional Education Board, teachers pay an average of $200 less in monthly premiums for single plans than private sector employees, but an average of $257 more in premiums for family plans.

Megan Boren, project manager with the board, said her study of teacher compensation found most states in the Southeast have work to do because of the sizable cost gap between single and family coverage. Boren said she would not single out Mississippi as struggling in this area, but pointed to Alabama, Virginia, and Florida as exemplar states that have successfully kept costs down for employees.

“A lot of this is just tied to how health insurance is set up, and there’s not a lot of wiggle room or great strategies that an employer, government or otherwise, can take on these pieces,” Boren said. “Our hands are quite tied because of the way health insurance is structured in this country and some of the general policies around that.”

A bill moving through the Legislature this session would study the state health insurance system and make recommendations for legislation to be proposed in 2024. The task force, proposed by Senate Education Committee Chairman Dennis DeBar, R-Leaksville, would focus on the financial solvency of the plan, rate increases, benefits and comparisons to other Southeastern states.

“I just want to see a deep dive into why expenses keep going up and up,” DeBar said. “I don’t want insurance (costs) to be a deterrent to getting insurance and doing yearly check-ups, because on the back end, medical conditions may be worse off if people don’t treat them.”

Some teachers share his concern that current rates are discouraging employees from seeking preventive care.

“I get that if you have a catastrophic year, it’s there for you, but this should be so much more in a state that is so unhealthy,” said Jason Reid, a teacher in the DeSoto County School District.

Reid, a two-time cancer patient, has hit his out-of-pocket maximum with both diagnoses and experienced the safety net that the plan can provide, but said that because of rising costs, most of his colleagues feel like they never see a benefit. Reid added the insurance plan usually isn’t stopping people from becoming teachers, but that it is driving them away.

Advocates say a lack of investment from the state is also driving away other state employees. Brenda Scott, the president of the Mississippi Alliance of State Employees, said teachers got a “decent” raise last year, but that for other state workers, raises are “very rare.”

Scott said she would like to see raises for state employees to make it easier for them to afford premium increases when they come along, or for the state to expand Medicaid to give employees more coverage options.

“They’re not expanding Medicaid, which is meant to cover the working poor,” she said. “There’s a lot of state employees who would fit into that category.”

Adding to frustration with the insurance premium increase are other changes to the plan.

Multiple teachers expressed frustration with the declining quality of prescription drug coverage since the switch from Prime Therapeutics to CVS Caremark, a change that state officials said was made to save money on rising healthcare costs.

Renee Webber-Butler, a teacher in the Perry County School District, was informed after the switch that the ADHD medicine her 16-year-old son takes would no longer be covered. He had tried multiple medications and had negative side effects with some before finding success with Vyvanse, the medicine that was no longer being covered.

“I explained to him what was going on, and he said, ‘Mom, I’m not going to have to take that medicine where I’m mean and angry am I?’” Webber-Butler said. “How do you look at your kid and say, ‘Well, son, I’m sorry but … on educator salaries, we can’t (pay out of pocket.)’”

She said they found another medicine for him that will be covered, but called it “ridiculous” that her son has been on three different medicines in six months.

Cindy Bradshaw, the administrator of the state health insurance plan, said the switch to CVS Caremark, as well as the deductible and premium increases in recent years, are adjustments to balance the finances of the health insurance plan. The plan has been spending more on care than premiums could cover every year since 2016, which has significantly decreased the surplus reserves of the plan. The surplus was $247 million in 2012 and had dwindled to $64 million by the end of 2021, according to the plan’s actuarial report for 2021.

During the 2022 legislative session, the state health insurance plan was given $60 million in American Rescue Plan funds, and a bill has passed out of committee to give the plan another $30 million in federal pandemic relief funds this session.

When discussing the incremental actions of the state board that manages the health insurance plan, Bradshaw said, “We’re trying to softly land a plane instead of having a big crash.”

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This article first appeared on Mississippi Today and is republished here under a Creative Commons license.