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Despite the success of the joint city-county health clinic implemented to help both government entities control insurance costs, a nebulous cloud hangs on the horizon, shading the future of the program from view.
“We’re in good shape,” said Larry Clark, the city’s finance director said during a budget committee meeting prior to Tuesday’s City Council meeting. “With that said, the new healthcare law will require everyone to look at their plan and in ’14-’15 fiscal year, we may have to do adjustments in our current plan to increase the coverage.”
Clark said the current version of President Barack Obama’s healthcare law contains a stipulation about vision coverage that – unless the law is changed – will have to be addressed.
“We would have to at least meet minimum benefits as required by the federal government,” he said. “But what those are? Who knows, right now because it’s still ongoing? They’ve already changed it. When they brought out the regs on it? They already changed some of the regs, within the last two weeks.”
Clark said that unless it changes, there will be a monthly per participant charge.
“Again we won’t know until that time gets closer because it could change,” he said.
Councilmember Kay Senter questioned the budget status of the health clinic, which has costs running over budgeted projections.
Clark said that basically he had budgeted on an educated guess. The joint city-county clinic had only been in operation for half a year when budget time rolled around.
“I guessed. I guessed wrong,” Clark said. “Basically what I hit was six months’ worth so that number needs to be doubled. We’ll double that next year for sure. But even at that what premiums we’re (saving) is enough to cover those costs plus those BlueCross/BlueShield costs on it.”
“We’re still receiving a costs savings,” he added.
Whether the city can stay with the clinic for the long term may depend on the federal government’s definition of a “Cadillac plan.”
Clark said part of the healthcare law has a fee/tax for “Cadillac plans.”
“My concern is that they will consider any employer with a clinic to have a ‘Cadillac plan,’” he said, “especially if they’re not charging the employee anything for use. Right now it’s not. But I’m thinking I don’t know how the federal government will look at that because it’s something that a lot of people don’t have access to along with a regular health insurance provider.”
Mayor Danny Thomas said one thing to remember when discussing the clinic is the early detection savings of more than $1.5 million.
“The clinic has been good for both the city and the county as far as early detection for some health risk for employees who would have never gone to the doctor in the first place,” Clark said.
“What you also built up was trust,” Senter added, “in that it was OK to have something that needed to be checked out early.”
City Administrator Tony Cox said the city is also wrestling with how new healthcare regulations could affect part time and seasonal workers.
Clark told the budget committee the law mostly will affect workers like the city’s mowers and extra people for Public Works during the leaf collecting season.
“There may be some changes to that coming down the pike,” he said “Hopefully, knock on wood, there is and we can still use those folks. But that will be something that – if it doesn’t change – we’ll have to wrestle with for additional cost.”
Clark noted they’d been in touch with the city’s Strate Insurance representative.
“There will be changes,” Cox said. “We just don’t know if they will be good changes or bad changes.”
Other changes coming down the pike, ones that Cox expects to be bad changes will affect grant money available to cities in the wake of budgetary battles in Washington.
“I think the days of getting grants are about to dry up,” Cox said. “Generally, if Washington has to cut back, it’s easier to cut off what they’re giving as grants than to cut their staff. I would expect that to be the first phase.”
-By John Gullion, Tribune Managing Editor
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