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Wisconsin State Workers Will Start Paying More for Health Care

Out-of-pocket costs for health care will double next year for state workers, after Gov. Scott Walker signed the budget in July authorizing changes approved by the state's Group Insurance Board in May.

By David Wahlberg

Out-of-pocket costs for health care will double next year for state workers, after Gov. Scott Walker signed the budget in July authorizing changes approved by the state's Group Insurance Board in May.

Walker vetoed additional review by the Legislature's Joint Committee on Employment Relations. "I object to having the committee infringe on the responsibilities of the board," he wrote.

Out-of-pocket limits for medical services will go from $500 to $1,000 for individuals and $1,000 to $2,000 for families. Deductibles of $250 for individuals and $500 for families will be introduced.

Doctor visits, which had required workers to cover 10 percent of the bill, will have fees of $15 to see regular doctors and $25 to see specialists.

The maximum patient cost for prescription drugs will go from $50 to $200.

Those and other changes are designed to save $85 million over two years and avoid a "Cadillac" tax on rich benefit programs starting in 2018 under the Affordable Care Act, state officials said.

The $1.4 billion state worker health insurance program covers about 240,000 employees and family members, most of them in Dane County.

Segal Consulting, hired by the Department of Employee Trust Funds, recommended the changes.

Segal is expected to release proposed changes for 2017 in November.

Those recommendations could include self-insurance, in which the state would pay benefits directly instead of buying insurance from 18 HMOs. That could save $50 million to $70 million a year, Segal said in March.

Walker also vetoed proposed changes to the makeup of the 11-member Group Insurance Board.

The budget would have required the board's six gubernatorial appointees to be approved by the state Senate. It would have expanded the board to 15 members, including two appointed by the Senate and two by the Assembly.

Walker, in striking down the changes, called them "administratively burdensome."

(c)2015 The Wisconsin State Journal (Madison, Wis.)

Caroline Cournoyer is GOVERNING's senior web editor.
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