Some lawmakers raise concerns over benefit cuts

Some Nevada lawmakers raised concerns Wednesday that changes to public employee health insurance costs and benefits would be particularly harsh to lower wage earners, a sentiment shared by one tearful state worker who feared not being able to pay for her son's insulin to treat his diabetes.

Susie Giurlani said both she and her husband work for the state. Furloughs imposed in 2009 and other costs attached to their wages have reduced their monthly income by $600, she said.

"We are not the rich state employees that some people think we are," she told joint Assembly Ways and Means and Senate Finance subcommittee.

Under benefit plan changes approved by a board that oversees public employee and retiree health benefits, annual deductibles for family coverage will jump from $1,600 to $3,800. For an employee only, the deductible will raise from $800 to $1,900.

Total out-of-pocket costs will be capped at $7,800 for a family, and $3,900 for an individual.

Giurlani said a vial of insulin costs $430, and her son goes through 11 in three months.

She called the plan "punitive for people who do have health problems."

"I'm punished because I chose to get a job with the state, 30 years ago, believing that I'd have reasonable health coverage," she said through tears, adding she's "having a harder time in my life than when I was single."

The plan currently covers 72,000 active and retired public employees and their dependents. The benefits board is scheduled to meet today to determine how much more participants will pay toward their monthly premiums.

Jim Wells, executive director of the Public Employees' Benefits Program, said maintaining the status quo and subsidies paid by the state would have left an $85 million shortfall.

He said shifting to a high deductible medical plan will save $41 million over the next two years. The program also plans to shed Medicare-eligible retirees to a private health insurance exchange, saving another $22 million, and eliminating coverage for eligible spouse or domestic partners who have access to their own employer-paid plans. He estimated that savings at $9 million.

Wells said that to help offset higher costs, the program would establish and contribute to health maintenance and health reserve accounts for active and retired workers. He said participants could elect to add more on their own, which could eventually cover all their deductibles.

But Assemblyman Marcus Conklin, D-Las Vegas, and Sen. Mo Denis, D-Las Vegas, questioned the impact on lower wage earners and whether higher deductibles would lead to fewer doctor visits at the expense of care.

"That would be great for people who make enough money, but what about the people on the lower end who won't be able to save to cover the deductible?" Denis asked.

Conklin said having to shell out higher amounts to see a doctor - as opposed to the current $20 co-pay for most doctor visits - could discourage people from getting early treatment and end up costing more in the long run.

The budget hearing was continued to a later date.