CHARLESTON, W.Va. — The state Public Employees Insurance Agency Finance Board could change its mind about some non-generic prescription drugs used by some state workers.
Following the recently completed public hearings on next fiscal year’s health insurance plan, PEIA Executive Ted Cheatham said proposed cost increases for some preferred drugs may be changed.
“We’ve been working with CVS since we started the public hearing process because there are no generic alternatives for diabetic insulin, for example,” Cheatham said. “So disproportionately our diabetics with the tier structure we put together would be disadvantaged.”
The cost of prescription drugs in the current proposal would go to a 30 percent payment on preferred brand prescriptions, rather than a $25 or $30 co-pay.
Cheatham plans to propose the changes at the finance board’s Dec. 7 meeting.
“We’re looking at restructuring that to take care of our diabetics and our asthmatics that are most affected by those changes. We are looking at ways we can work around that to solve some of those problems,” he said.
Board members heard dozens of complaints on other issues during the public hearings. Those focused on changes to the tier system, plans for total family income and a proposal to pay for insurance by the individual. Cheatham said changes could be less likely there because those are more philosophical differences.
“The ‘ability to pay’ is what the statute says and I think the board and the legislature believes the ability to pay should include total family income,” Cheatham said.
AFT-West Virginia President Christine Campbell has been among those to express concern about the changes particularly collapsing 10 salary tiers that determine premium payments to three. Campbell said that means increased premiums for those earning less.
“It’s shifting the premium costs. So people who make more money are actually getting a break,” Campbell said.
Cheatham said ultimately it’s the PEIA board that will make the decisions on what the plan will look like.
“They could indeed decide it’s not time for total family income or they could decide it’s not time to pay by the person. The board may believe that,” he said.