According to this Raleigh News & Observer article, we’ll find out over a year from now before fall open enrollment in 2024 just what the change in health plan administration from Blue Cross Blue Shield of NC to Aetna will cost members in terms of plan benefits, coverage, access to current providers, treatment paths, etc.
It’s concerning that the “lower cost” claim details supposedly part of this agreement will not be shared with state health plan members for over a year. The delay in detail is particularly perplexing especially since Treasurer Dale Folwell referenced the pursuit of additional “transparency” as one of the motivating factors for the change.
The last time Folwell disrupted state employee and teacher health plan prospects was in 2019 when he issued an ultimatum to health care providers to either accept his lower reimbursement rates through his “Clear Pricing Project” or be kicked out of the state health plan network. At the time, I expressed concern over this showdown that risked jeopardizing over 700,000 people’s health care access in this original post and in NC Policy Watch here.
The recent revelation that the state health plan will have a new company administering claims in order to save around 1% ($140 million saved on $17.5 billion in costs) doesn’t seem to be a strong enough justification to shake up administration companies and leave members wondering for nearly two years what their health coverage and costs will look like under Aetna.
Given his failure to follow his own investment plan for the state pension while bragging about cost savings (saving on fees by not investing money), it’s no surprise Folwell would see no issue with shaking up 700,000 people’s health coverage for a 1% savings.
If the Treasurer is so confident there will be additional savings based on the contract offered to Aetna, he should be transparent and share those details to address members’ legitimate concerns. Based on this article in the News & Observer, it seems those details have not yet been worked out.
In 2019 when state health plan members desperately sought an amenable resolution to the Clear Pricing Project showdown, a reporter asked Folwell to respond to plan members’ concerns. His opaque reply: “Stay tuned.”
There’s speculation that the change from BCBS NC to Aetna may be in retribution for BCBS not meeting Folwell’s price transparency expectations. Folwell has a history of spite when he doesn’t get his way – I have a bogus cease and desist letter from the Treasurer’s office in response to my advocacy during the Clear Pricing Project fiasco to prove it.
Over half of US states have laws related to health care price transparency. Instead of trying to single-handedly manhandle health plan administrators a few years after he tried to manhandle health care providers in 2019 with the “Clear Pricing Project,” Folwell could use his platform to encourage the NC General Assembly to pass a health care price transparency law. That could help all North Carolinians, not just state employees, and would prevent future draconian efforts by Treasurer Folwell to disrupt health care in the name of “transparency” for those who teach, protect and serve our state.
I’ll continue to follow and the developments of the health plan administration change, and begin to share more about pension concerns I’ve expressed with others over the last two years during public comment of the Investment Advisory Committee meetings. To borrow a phrase from Treasurer Folwell…
stay tuned.
educatEDpolicy 
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