As I walked out of the Hynes Event Center in Mercedes Monday, October 23, I felt sick. Literally. I also felt angry….and sad…and worried. How could Texas legislators do this to public school employees who spent years teaching our state’s children, caring for their physical and emotional needs, feeding them, keeping the facilities clean, answering the phone and greeting parents and community members, and doing everything else school district employees do?
I had just left a Texas Teacher Retirement System session about the changes to our healthcare plans, compliments of the 85th Texas Legislature. For those of us who are under 65, our plan is called a “High Deductible Health Plan.” Healthcare.gov describes an HDHP like this: “A plan with a higher deductible than a traditional insurance plan. The monthly premium is usually lower, but you pay more health care costs yourself before the insurance company starts to pay its share (your deductible).” Perfect description.
I already knew the 85th Texas Legislature raised our deductible from $400 to $1500. I also knew I would no longer have a co-pay. What does that mean? It means that now when I go to the doctor or pharmacy (That’s right! I no longer have a pharmacy co-pay, either.), instead of paying approximately $25, I will pay the full bill until I reach my $1500 deductible. No problem. As a wealthy retiree, $1500 is chump change. Oh, wait! I am a retired teacher. Fifteen hundred dollars is a lot of money.
Once I reach my $1500 deductible, Aetna will pay 80 percent of my medical bills and prescription drugs, if I use an in-network doctor. When I have paid $5650 out of pocket to in-network facilities, physicians, and pharmacies, Aetna will pay 100 percent of my in-network medical costs.
The more the presenter talked, the sicker I felt. I couldn’t imagine how retired public school employees whose spouse is covered under their TRS healthcare must have been feeling. For them, grim couldn’t even begin to describe their situation. The deductible for public school retirees with two or more family members on their healthcare plan is $3000. You would think that means $1500 for the retiree and $1500 for the spouse, but that’s not the case. Thanks to our Texas legislators, those retirees must pay 100 percent of their medical and prescription costs until they have spent $3000 out of pocket. So even if the retiree has already paid $1500 for medical and pharmaceutical bills, he/she has to keep paying until $3000 has been spent. However, when it comes to the family’s maximum-out-of-pocket, that is figured on an individual basis rather than by family. Go figure.
Texas Legislators, how well do you know the statistics? According to the Texas Retired Teachers Association, TRS has more than 375,000 retirees whose average monthly pension is $2035. But what’s even worse…much worse…is that 30 percent of TRS retirees, roughly 105,000, receive $1000 or less per month. How in the world do they expect these dedicated public school retirees to afford the healthcare they have subjected us to?
But why should they worry? After all, remember--they kept all other state employees, whose healthcare is covered by the Employees Retirement System of Texas rather than by TRS, at a $0 deductible. And don’t forget—that includes retired legislators who have served at least eight years. So I served the children of this state for 29 years, and I have a $1500 deductible with no co-pay, and they can serve eight years and pay a $0 deductible?
Texas Legislators, how could you?
(Note: Last week, Eloise Montemayor, community relations/public sector associate with United Way of South Texas shared information with me about FamilyWize, a United Way partner that reduces the cost of prescription medicine through agreements with pharmacies nationwide. FamilyWize is for individuals with and without insurance, there is no cost to use FamilyWize, and there are no income qualifications. Go to familywize.org and print out a card or download the app. For any prescription medication you need to purchase, visit their site and find the local pharmacy that will give you the best deal. When you go to pick up your prescription, show them your card. At this point, every penny counts.)
Chris Ardis retired in May of 2013 following a 29-year teaching career. She now helps companies with business communications and social media and works as a sales coordinator for Tony Roma's and Macaroni Grill. Chris can be reached at email@example.com. (Photo by Sarina Manahan)