We are disappointed that the PEIA Finance Board decided to approve the Governor’s plan recommendations instead of those put forth by the PEIA Task Force. This means participants will receive the 80/20 rate at facilities in bordering counties only.
Allowing plan participants to go to any in-network facility at the 80/20 rate would have leveled the playing field for all. Instead, some participants will be required to continue traveling long hours and pay a higher price in order to receive the health care they need.
However, we are pleased with other aspects of this plan. This is the first time in several years that a plan by PEIA actually returns money to the plan participants instead of taking more money from their paychecks.
The appeals process for third tier drugs is another great way for people to save money. We highly encourage that the majority of these appeals be granted as we feel that a doctor knows best what is right for the patient.
As we saw in projections during the PEIA Public Hearings over the past couple of weeks, the plan includes no increases in premium costs for active or retired participants. However, projections for future years do not look as favorable. This is why it is so important that we continue to lobby the legislature and ask for a long-term funding solution. Without funding, all plan costs will eventually rise exponentially in the coming years.
We need to continue to work on solutions for PEIA this legislative session. Those solutions need to include both cost containment and funding recommendations.