A recent poll shows healthcare costs are voters’ top financial concern. Employer and union health plans like the one I oversee at the New Jersey State Policemen’s Benevolent Association are on the front lines of this healthcare cost crisis. Collectively, these plans provide coverage for 160 million Americans.
Over the last two years, our health plan costs increased by 31% to an average of $43,000 per policyholder. Today, our 30,000 active-duty police officers must pay upwards of $15,000 annually for coverage. Taxpayers pay the rest. Next year, hospital surgery costs are expected to drive our plan costs up another 15%, bringing annual premiums to nearly $50,000.
Other employers and unions nationwide are facing similar cost overruns. With the proliferation of high-deductible health plans, many employees and union members cannot even access their coverage until they have drained their savings account. No wonder people are fed up.
Our union recently sent a letter to Congressional leaders signed by 75 unions, employers, and nonprofits, representing 21 million workers and 55 million covered lives, asking them to support a bipartisan Senate bill that will empower health plans to reverse these runaway health care costs.
The Health Care PRICE Transparency Act 2.0 grants union and employer health plans access to our health claims data, allowing us to compare billing information to prices and hold our insurance carriers accountable.
This claims information can prevent insurance carriers from paying providers more than what’s billed, a cost-driver I’ve noted numerous times with our plan. Yet when I’ve raised this issue with colleagues, I’ve been gaslit and told this is simply how carriers operate.
Congress is currently reconciling this Senate bill with a bipartisan House of Representatives price transparency bill with the goal of including the final package as part of broader upcoming legislation. The Senate bill goes further than the House bill by including this critical claims payment information provision. It is union, employer, and patient-friendly.
When employers and unions can audit our health claims, we can perform fundamental plan oversight and design plans with quality, less expensive care. Then we can share ensuing savings with employees in the form of higher wages and lower premiums. Health care can become more affordable, accessible, and equitable.
Unfortunately, under the status quo, health insurance companies routinely block unions and employers from their plans’ claims information, fighting us tooth and nail to keep it secret.
When price information is hidden, hospitals and health insurers can collude to overcharge us with impunity–hence the outrageous health care cost increases burdening ordinary Americans. According to the Kaiser Family Foundation, 100 million Americans are saddled with health care debt.
Unions and employers are fighting back. Some are even suing their health insurance companies for access to their claims information after discovering they’d been dramatically overbilled. For instance, the Bricklayers and Sheet Metal Workers allege their health insurer hid behind unlawful gag clauses to prevent the unions from accessing their own health plan claims.
The unions allege the limited claims information they were able to access showed the insurer substantially overcharged the plans, resulting in reduced pension fund contributions and increased health plan deductibles. It’s the same story at my union. Health care price transparency legislation that grants us access to claims data can stop these cost overruns before they occur.
Police have embraced body cameras in the face of enormous public scrutiny because we understand that transparency is the bedrock of trust and accountability. Yet healthcare is the least transparent part of our economy even though it makes up nearly one-fifth of GDP.
As 75 unions, employers, and nonprofits attest, the Senate healthcare price transparency legislation finally shines a light on healthcare prices and empowers health plans to substantially reduce crushing costs. You shouldn’t need to be a detective to figure out health care prices.
Kevin Lyons is the director of member benefits for the New Jersey State Policemen’s Benevolent Association.
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