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Arizona's universities want out of the state's health insurance program, saying politicians have used money for health care to balance the budget.
ASU, UA want out of state health plan. Here’s why Arizona's universities want out of the state's health insurance program, saying politicians have used money for health care to balance the budget. Check out this story on azcentral.com: https://azc.cc/2GBa0Of
Rachel Leingang, The Republic | azcentral.com Published 6:00 a.m. MT April 5, 2018 | Updated 2:55 p.m. MT April 5, 2018
Arizona State University and University of Arizona want to separate from the state of Arizona’s health insurance program, saying politicians used university money intended for health care to balance the state budget.(Photo: Michael Schennum/The Republic)
Tens of thousands of employees at Arizona State University and the University of Arizona could have better health insurance, potentially at a lower cost, if the universities get their way.
But first they have to convince state lawmakers and the governor that they should be allowed to set up their own insurance programs, something officials fear could decimate the state's health insurance fund.
The schools want to separate from the state of Arizona’s health insurance program, saying politicians for years have used university money intended for health care to balance the state budget.
In addition, university employees are overpaying for health insurance now through the state system, ASU said. If ASU and UA left the state plan, ASU estimated the two schools combined could save about $30 million per year.
“We do believe this would result in lower costs and allow for greater flexibility for employees overall,” ASU spokeswoman Katie Paquet said.
The state system covers nearly 47,000 ASU and UA employees, including their dependents, and the universities make up more than one-third of the approximately 138,000 of the people in the state health insurance system.
ASU and UA point to studies they commissioned that show the universities are subsidizing the state system because university employees are healthier than the general state worker population.
University employees live in metropolitan areas, which tend to have lower costs for health care, Paquet said. They also typically have higher education and income levels, which contribute to better health outcomes, she said.
But if the schools are allowed to pull out, it could devastate the state health insurance system, potentially creating higher costs for the state and its other workers.
The decision to leave isn't up to the universities. They would need legislation or executive action to leave the system, and it’s unclear if Gov. Doug Ducey and lawmakers would risk toppling the state health insurance system.
“We’d see a big loss for the state if they were to break out from the system. ... We really don’t think it would be appropriate for the state to lose money to see a savings in one sector of government,” said Daniel Ruiz, a policy adviser to Ducey.
While the universities estimate they could save money by leaving, Ruiz said the health insurance fund likely would see a decreaseto the fund larger than the amount the universities save, meaning less money to pay for health care costs.
Additionally, the larger the health insurance pool is, the more buying power the state has to get the best insurance options possible for the lowest cost, Ruiz said.
The state health insurance program runs on five-year bidding cycles, and the next bid for services goes out in 2019, according to the Arizona Department of Administration.
University officials are pushing to exit the program now and are meeting with lawmakers and the governor's office to make their case in advance of the 2019 bid.
All insurance pools involve some users subsidizing others, since some people have more health needs and use insurance more than others.
But it’s not just the subsidizing that irks the universities. It’s the political whims and budget shortfalls that can affect how their money is used.
“There’s no way to do it, as far as I can tell, that allows one side to be a winner and the other side not to be a loser, so we have to keep that in perspective.”
The state’s Health Insurance Trust Fund is supposed to pay for medical needs for state workers. But the lingering financial downturn after the Great Recession led state leaders to raid surplus health insurance funds totaling more than $300 million over several years, leaving little financial cushion to cover increased health insurance costs.
From fiscal year 2010 to 2017, the state took $311 million from the health insurance trust fund and used it to pay for things out of the general fund and to balance the state budget.
Ruiz said the money taken by the state was used for basic needs, like payroll, as Arizona was forced to make difficult decisions because of the lingering financial crisis.
Some of that money came from students' tuition. ASU estimates about $17.8 million of the total state leaders took to balance the budget came from tuition dollars.
After years of fund raids and increasing health care costs, the health insurance trust fund couldn’t sustain itself. There was no buffer to account for increased costs. Premiums had to increase for the state to pay its health care bills.
Premiums had remained flat for many years, something ASU said was done as an incentive for state workers who hadn't seen raises as the state weathered the financial downturn.
But this year, premiums for state health insurance increased by 12.6 percent. The state has proposed another increase for 2019 of about 5 percent.
It’s not just university employees who saw increased premiums. All state employees were told they would have to pay more for health insurance this year and next.
While some lawmakers have argued that funding sweeps made premiums increase, Ruiz said health care costs have gone up in the past few years for most people, including state workers.
While part of the reason for splitting with the state is financial, the universities also say they could better design health insurance programs for their employees.
“The state hasn’t demonstrated a desire to keep medical costs low for their employees. It’s health care truancy at its best.”
That idea has a lot of support from faculty members, said Lynn Nadel, the chair of the Arizona Faculties Council and a professor at UA. He said the state system has constraints on coverage that a university-only system could hopefully cover, like health care needs for employees who are transgender.
“From the faculty perspective, if we can do this on our own, then we will actually be able to cover a broader base of coverage for all of our colleagues,” Nadel said.
ASU’s chief financial officer, Morgan Olsen, said the two schools aren’t sure if they would partner or have separate systems if they’re allowed to leave the state program.
He said ASU could alter coverage to create incentives for healthy living, like using preventative care instead of emergency rooms, utilize its partnerships with the health care industry and install care facilities on campus to improve access.
How do Americans get their health insurance and who’s covered? We went to the National Center for Health Statistics for answers based on a 2015 survey. Getty Images
In 2015, an estimated 28.6 million Americans, or 9.1 percent of the population, did not have health insurance. That’s an improvement. In 2014, 7.4 million fewer Americans had health coverage. Getty Images
For those under 65 who are insured, 65.6 percent had private coverage and 25.3 percent had public coverage. Getty Images
Among those under age 65, 3.4 percent or 9.1 million people obtained coverage through Affordable Care Act exchanges. Getty Images
When looking at racial and ethnic breakdowns, the percentages without health insurance are: 27.7 percent of Hispanics, 14.4 percent of Blacks, 8.7 percent of Whites and 7.9 percent of Asians. Although Hispanics remain the largest ethnic group without coverage, there has been dramatic improvements. The uninsured rate for Hispanics was 40.6 percent in 2013. Getty Images
Ducey has pushed all state agencies to find efficiencies, and health insurance is one way universities can be more efficient with their dollars, said Gregg Goldman, UA’s chief financial officer.
But Goldman also said it’s reasonable for the governor and lawmakers to take a more holistic approach to health insurance for state employees.
“Clearly our desire and our interest is to try to do what’s best for our employees … to try to take the limited resources we have and use them in continuing, productive ways,” Goldman said.
The state would lose some of its buying power if a large portion of its health care users left the program, Ruiz said, and the governor has to consider employees at all agencies and what’s best for the whole system.
Arizona House Speaker J.D. Mesnard, R-Chandler, said he’s willing to discuss the possibility of universities breaking off, but the costs to the entire system are a major consideration. If the schools left, the state would have to kick in more money to keep the system whole, leaving less money available for other priorities, like education funding, he said.
“There’s no way to do it, as far as I can tell, that allows one side to be a winner and the other side not to be a loser, so we have to keep that in perspective,” Mesnard said.
Rep. Mark Cardenas, D-Phoenix, said the fund functioned as the Legislature’s “personal piggy bank” for the past eight years, and the universities are likely tired of it. They could find better uses for their money, he said. He said there’s no easy decision, but he leans in favor of letting the universities leave.
“The state hasn’t demonstrated a desire to keep medical costs low for their employees. It’s health care truancy at its best,” Cardenas said.
Three years after going 13-0 and winning a state title, Joy Christian is dropping football for next Arizona high school season
Joy Christian dropping football 3 years removed from state title Three years after going 13-0 and winning a state title, Joy Christian is dropping football for next Arizona high school season Check out this story on azcentral.com: https://azc.cc/2Fnme7G
Joy Christian lifts its trophy after winning the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Joy Christian's Isaiah Goodspeed (80) lifts the trophy with his teammates after winning the Division V State Championship against Benson at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Benson's Nick Hernandez (8) pitches under pressure from Joy Christian's Joshua Keith (81) during the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Joy Christian's Dujuan Lawrence (2) and quarterback Matt Mitchell (16) during the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Joy Christian's Tyler Graham (44) breaks a tackle from Benson's Keegan Graf (44) during the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Joy Christian's Matt Mitchell (16) throws a pass against the Benson defense during the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Joy Christian's Dujuan Lawrence (2) scores a touchdown against Benson's Tyson Coleman (7) during the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Joy Christian's Matt Mitchell (16) passes over the defense of Keegan Graf (22) during the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Benson's Nick Hernandez (8) passes under pressure from Joy Christian's Jonathan Herrera (40) during the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Benson's Nick Hernandez (8) scrambles out of the pocket against Joy Christian's Arrick Dowe (3) during the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Benson's Tyson Coleman (7) reacts after dropping a pass against the Joy Christian defense during the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Joy Christian's Joey Morin (53) tackles Benson's Brandon Laird (34) during the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Joy Christian's Dontae Gilbert (5) and Ramon Santos (58) dump the cooler of ice on head coach Brian Cole after winning the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz. Patrick Breen/azcentral sports
Joy Christian lifts its trophy after winning the Division V State Championship at Chaparral High School on Nov. 28, 2015 in Scottsdale Ariz.
Richard Obert, azcentral sports Published 2:00 p.m. MT April 27, 2018 | Updated 2:07 p.m. MT April 27, 2018
Glendale Joy Christian High School won the Div. V Arizona state football title in 2015.(Photo: Nick Oza/The Republic)
Since Cole left, Joy Christian, under two different coaches, went 0-8 in 2016, getting outscored 426-34, and 1-9 in 2017, outscored 475-86.
Cole, now the head coach at Phoenix Christian, was part of the big sports movement at the private school in 2011, leaving Phoenix North Canyon, which he led to an unbeaten state championship season at the 5A level.
Joy Christian went 53-6 and won two state titles (first in the 1A, 8-man level) and played in three state finals in Cole's five-year tenure. Cole told azcentral sports in 2016 that he left after a change in leadership, because he didn't agree with the school's new athletics vision.
"We had some really good teams at Joy," Cole said in an email this week. "It’s pretty sad, but not really a surprise. It will be interesting to see if other sports follow."