Some chapters are fighting to preserve the coverage they've got, while others are facing difficulty finding health care providers willing to cover them at all.
A crisis in health care coverage has been building across the state and the nation, and is beginning to hit CTA members right in the pocketbook.
After a brief reprieve during the Clinton presidency, health care costs have returned to double-digit increases each year and are expected to rise again this year.
"It doesn't look good for health care costs. Already we're seeing increases of 15 to 30 percent in costs, and no one at the state or federal level is addressing the issue," says Susan McClure, a health care consultant with CTA's Member Benefits Department.
In spite of the pessimistic outlook, chapters are making some gains - or at least being successful at preserving what they have. Many of the contracts that have been bargained recently include an agreement to continue district coverage of health costs, or to add a 1 to 2 percent increase to cover insurance costs.
But the challenges around the state are as numerous as they are diverse.
Rural chapters, for example, are having an especially difficult time even finding health care providers. Other areas are finding their choices dwindling as well.
This fall, the Health Plan of the Redwoods in Sonoma County closed down, forcing thousands of participants in that plan to pay much higher premiums to for-profit health plans without gaining any benefits. The move has forced some chapters, like Valley of the Moon in Sonoma, to go back to the bargaining table and reopen the issue of health benefits. The members who belonged to the health plan were able to transfer to another one that has higher premiums and higher co-payments, according to chapter president Kevin Evans. At this point, the district has agreed to pick up premiums for six months, although it has also declared impasse in the negotiations.
How well a chapter is able to negotiate health benefits often depends on whether they are in the contract in the first place.
"Chapters with contracts where employers pay full costs are in a better situation than other chapters," says Marty Kahn, a CTA staff consultant in the Negotiations and Organizational Development Department. "But there may be an impact on the type of salary increases they get."
CTA's Negotiations Department is seeing more and more contracts like the following:
- Monterey County Office of Education Teachers Association negotiated a 4.04 percent package for 2002-03, which includes a 2.75 percent salary schedule increase and 1.29 percent to cover the increase in benefit costs.
- Santa Cruz County Education Association, faced with a 22.85 percent increase in the cost of medical benefits, settled for a 2.01 percent package for 2002-03, with the entire amount going towards benefits.
- Westminster Teachers Association reached a settlement that includes a total compensation of 4.7 percent, with 2.7 percent applied to salaries and 1.7 percent to health and welfare benefits.
In chapters that have monetary caps on benefits, bargaining teams may find themselves in the difficult position of having to get those caps raised.
The United Teaching Profession of Goleta, for example, agreed to a 2.6 percent salary increase that included a $500 increase to the health and welfare benefits cap.
A more preferable solution for some chapters is to join a jointly managed trust, commonly known as a Voluntary Employees Beneficiary Association (VEBA). A trust is a separate organization of employees and employers who work together to purchase health care benefits. The trusts are tax-exempt and are governed by a board of directors that contracts with health providers to design health plans that meet the needs of their members.
However, if there isn't an existing trust available, CTA recommends caution in starting one. It's a costly, laborious process to try to start one from scratch, says Kahn.
One other option for bargaining teams to consider is joining the California Public Employees' Retirement System health program, which, unfortunately, had been a more attractive choice before it raised rates and reduced the plans available. Still, becoming part of a statewide pool may be a solution for some.
Chapters around the state are already involved in cost containment ideas that include requesting generic drugs when filling prescriptions or raising the co-payments for health plans. While higher co-payments for a doctor's visit can lower the costs of the health plan dramatically, members often object to paying more for visits.
There are no immediate solutions to the health care crisis, Kahn warns, and the problems vary depending on the chapter's geographic location. Some solutions are unique, if not optimal. The Oakland Education Association, he says, has been exploring the possibility of joining a joint trust in the Central Valley in order to bring its health care costs in line.
One long-term solution under consideration by CTA is to support the introduction of single payer health care legislation in 2003. So far, Health Care for All - California, a nonprofit grassroots organization working in coalition with 30 other organizations around the state, has convinced state Sen. Sheila Kuehl (D-Santa Monica) to sponsor a bill in the coming legislative session. CTA's State Council of Education is likely to consider it once the bill is officially proposed at the beginning of the new year. In January, Kuehl will discuss her ideas about health insurance at CTA's Rural Issues Conference in Las Vegas.
Dale Martin
