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State employee health plans
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State employee health insurance accounts for the second-largest portion of state healthcare spending, behind only Medicaid. The total cost of insurance for state workers was $30.7 billion nationwide in 2013, with $25.1 billion paid for by the states. Premium costs varied widely, with higher premiums found in states such as New Hampshire and Vermont compared to those in states like Arkansas and Mississippi. Part of this variation is due to demographic factors and provider prices, and part may be attributed to differences in what is known as health plan richness, or the cost sharing between the insurer and health plan enrollees, such as deductibles and copayments.[1]
| “ |
State health plans were generally "rich," paying on average 92 percent of the typical enrollees’ health care costs. By way of context, these plans would be designated "platinum" plans within the new health insurance marketplaces.[2] |
” |
| —The Pew Charitable Trusts | ||
Several states are experimenting with various cost-containment methods. "Pooled public employee health benefit programs" are one such strategy, which merges state employee health plans and those of other, smaller public employers, such as city governments and school districts. The idea is to save on administrative costs for insurers and leverage the larger pool to negotiate lower premium rates. Evidence of cost savings is mixed, with the smaller public employers reaping most of the benefits. Programs for pooling public employee health plans have been implemented in 31 states.[3]
Between 2011 and 2013, net expenditures for state employee health plans nationwide decreased by about 1 percent. The average premium for single plans in 2013 was $570 per month, and for family plans it was $1,233 per month.[1]
State employee health plan spending
The table below displays spending totals for state governments on employee health plans, as well as the change between 2011 and 2013 in each state. Nebraska saw the largest decrease in such expenditures during that time at 22 percent. Meanwhile, Hawaii saw the largest increase, 39 percent.[1]
Note: Due to such variations as demographics, plan richness and provider rates, "higher spending is not necessarily an indication of waste, and lower spending is not necessarily a sign of efficiency."[1]
| State employee health plan spending (in thousands) | |||||||
|---|---|---|---|---|---|---|---|
| State | Total state expenditures (gross) | Change | Total state expenditures (net) | Change | |||
| 2011 | 2013 | 2011 | 2013 | ||||
| Alabama | $319,012 | $299,038 | -6% | $244,199 | $222,317 | -9% | |
| Alaska | $85,541 | $98,993 | 16% | $80,828 | $95,760 | 18% | |
| Arizona | $643,261 | $611,180 | -5% | $575,517 | $546,816 | -5% | |
| Arkansas | $197,142 | $211,181 | 7% | $135,036 | $151,762 | 12% | |
| California | $2,394,406 | $2,594,322 | 8% | $1,854,783 | $2,008,166 | 8% | |
| Colorado | $232,886 | $255,009 | 9% | $198,617 | $212,794 | 7% | |
| Connecticut | $792,597 | $748,368 | -6% | $676,750 | $640,886 | -5% | |
| Delaware | $434,778 | $421,270 | -3% | $394,218 | $378,873 | -4% | |
| Florida | $1,709,924 | $1,600,160 | -6% | $1,483,773 | $1,388,552 | -6% | |
| Georgia | $562,834 | $596,437 | 6% | $432,056 | $432,725 | 0% | |
| Hawaii | $388,456 | $475,080 | 22% | $196,731 | $274,419 | 39% | |
| Idaho | $176,243 | $185,724 | 5% | $160,547 | $168,004 | 5% | |
| Illinois | $1,437,226 | $1,445,274 | 1% | $1,254,846 | $1,277,612 | 2% | |
| Indiana | $285,790 | $281,023 | -2% | $254,772 | $227,826 | -11% | |
| Iowa | $337,110 | $294,531 | -13% | $324,734 | $284,875 | -12% | |
| Kansas | $333,327 | $315,503 | -5% | $252,369 | $242,313 | -4% | |
| Kentucky | $320,842 | $325,409 | 1% | $245,138 | $247,361 | 1% | |
| Louisiana | $428,832 | $388,490 | -9% | $286,817 | $259,850 | -9% | |
| Maine | $187,912 | $168,110 | -11% | $160,755 | $133,077 | -17% | |
| Maryland | $818,422 | $832,815 | 2% | $664,594 | $676,735 | 2% | |
| Massachusetts | $1,088,666 | $1,123,453 | 3% | $814,743 | $840,959 | 3% | |
| Michigan | $544,571 | $513,122 | -6% | $451,303 | $421,767 | -7% | |
| Minnesota | $636,916 | $650,843 | 2% | $586,588 | $599,412 | 2% | |
| Mississippi | $323,775 | $315,057 | -3% | $251,250 | $243,504 | -3% | |
| Missouri | $485,182 | $469,779 | -3% | $383,611 | $366,946 | -4% | |
| Montana | $125,260 | $126,146 | 1% | $117,986 | $114,348 | -3% | |
| Nebraska | $195,532 | $151,944 | -22% | $154,471 | $120,036 | -22% | |
| Nevada | $249,849 | $231,934 | -7% | $213,909 | $191,121 | -11% | |
| New Hampshire | $175,628 | $181,458 | 3% | $167,580 | $169,977 | 1% | |
| New Jersey | $1,373,931 | $1,585,271 | 15% | $1,296,545 | $1,442,024 | 11% | |
| New Mexico | $170,827 | $141,909 | -17% | $119,578 | $99,335 | -17% | |
| New York | $2,646,170 | $2,628,715 | -1% | $2,208,734 | $2,008,619 | -9% | |
| North Carolina | $1,287,932 | $1,384,628 | 8% | $808,739 | $862,289 | 7% | |
| North Dakota | $148,546 | $153,828 | 4% | $148,546 | $153,828 | 4% | |
| Ohio | $552,207 | $558,156 | 1% | $460,642 | $470,481 | 2% | |
| Oklahoma | $367,381 | $329,316 | -10% | $367,381 | $329,316 | -10% | |
| Oregon | $749,358 | $755,073 | 1% | $749,358 | $717,319 | -4% | |
| Pennsylvania | N/A | N/A | N/A | N/A | N/A | N/A | |
| Rhode Island | $151,015 | $162,333 | 7% | $120,812 | $129,867 | 7% | |
| South Carolina | $398,741 | $423,073 | 6% | $289,021 | $310,733 | 8% | |
| South Dakota | $89,070 | $83,576 | -6% | $75,584 | $71,239 | -6% | |
| Tennessee | $775,292 | $788,116 | 2% | $627,953 | $635,043 | 1% | |
| Texas | $1,768,987 | $1,934,805 | 9% | $1,467,911 | $1,603,648 | 9% | |
| Utah | $220,376 | $205,677 | -7% | $209,529 | $187,035 | -11% | |
| Vermont | $93,959 | $94,088 | 0% | $75,168 | $75,271 | 0% | |
| Virginia | $910,886 | $899,135 | -1% | $813,062 | $788,561 | -3% | |
| Washington | $1,112,783 | $1,131,014 | 2% | $982,450 | $962,552 | -2% | |
| West Virginia | $305,171 | $303,365 | -1% | $223,082 | $216,775 | -3% | |
| Wisconsin | $1,155,116 | $1,117,769 | -3% | $1,090,626 | $976,360 | -10% | |
| Wyoming | $121,589 | $100,647 | -17% | $110,623 | $92,325 | -17% | |
| United States | $30,311,259 | $30,692,147 | 1% | $25,263,863 | $25,071,413 | -1% | |
| Note: "Gross expenditures include employer and employee premium contributions. Net expenditures include only employer premium contributions. All spending figures are in 2013 dollars." Source: The Pew Charitable Trusts, "State Employee Health Plan Spending" | |||||||
Below are average monthly premiums for state employees along with employer and employee contributions by state. According to the Pew Charitable Trusts, "States that are reported as having a negative contribution (credits) offer cafeteria-style plans in which the employer gives the employee a benefit allowance that can be applied to a range of offerings, often including medical, dental, vision, and disability insurance. ... A reported negative contribution does not necessarily mean that the employee will receive additional cash for choosing a particular benefit."[1]
| Average state employee health plan monthly premiums, 2013 | ||||||||
|---|---|---|---|---|---|---|---|---|
| State | Single | Family | Employer contribution percentage | Employee contribution percentage | ||||
| Total premium | Employer contribution | Employee contribution | Total premium | Employer contribution | Employee contribution | |||
| Alabama | $383 | $298 | $85 | $1,038 | $763 | $275 | 74% | 26% |
| Alaska | $1,375 | $1,330 | $45 | $1,375 | $1,330 | $45 | 97% | 3% |
| Arizona | $602 | $557 | $44 | $1,409 | $1,244 | $165 | 89% | 11% |
| Arkansas | $415 | $327 | $88 | $902 | $612 | $290 | 72% | 28% |
| California | $646 | $494 | $152 | $1,465 | $1,127 | $337 | 77% | 23% |
| Colorado | $446 | $405 | $41 | $1,027 | $825 | $203 | 83% | 17% |
| Connecticut | $608 | $543 | $65 | $1,534 | $1,297 | $237 | 86% | 14% |
| Delaware | $563 | $506 | $57 | $1,203 | $1,081 | $121 | 90% | 10% |
| Florida | $549 | $500 | $50 | $1,242 | $1,063 | $179 | 87% | 13% |
| Georgia | $518 | $395 | $122 | $1,171 | $833 | $338 | 73% | 27% |
| Hawaii | $435 | $251 | $184 | $1,237 | $714 | $523 | 58% | 42% |
| Idaho | $458 | $421 | $37 | $1,063 | $958 | $105 | 90% | 10% |
| Illinois | $692 | $633 | $60 | $1,545 | $1,348 | $197 | 88% | 12% |
| Indiana | $517 | $379 | $138 | $1,378 | $1,120 | $258 | 81% | 19% |
| Iowa | $518 | $518 | $0 | $1,211 | $1,136 | $74 | 97% | 3% |
| Kansas | $552 | $472 | $80 | $969 | $689 | $280 | 77% | 23% |
| Kentucky | $653 | $577 | $76 | $1,258 | $815 | $443 | 76% | 24% |
| Louisiana | $547 | $410 | $137 | $1,031 | $652 | $379 | 67% | 33% |
| Maine | $728 | $655 | $73 | $1,539 | $1,151 | $387 | 79% | 21% |
| Maryland | $621 | $503 | $117 | $1,275 | $1,037 | $239 | 81% | 19% |
| Massachusetts | $585 | $437 | $148 | $1,418 | $1,062 | $356 | 75% | 25% |
| Michigan | $496 | $407 | $89 | $1,174 | $964 | $210 | 82% | 18% |
| Minnesota | $503 | $503 | $0 | $1,480 | $1,333 | $146 | 92% | 8% |
| Mississippi | $391 | $356 | $35 | $729 | $356 | $373 | 77% | 23% |
| Missouri | $551 | $460 | $92 | $1,292 | $990 | $301 | 78% | 22% |
| Montana | $712 | $733 | -$21 | $890 | $733 | $157 | 91% | 9% |
| Nebraska | $471 | $372 | $99 | $1,366 | $1,079 | $287 | 79% | 21% |
| Nevada | $631 | $552 | $79 | $1,111 | $875 | $236 | 82% | 18% |
| New Hampshire | $659 | $616 | $43 | $1,778 | $1,666 | $112 | 94% | 6% |
| New Jersey | $758 | $663 | $95 | $1,623 | $1,490 | $134 | 91% | 9% |
| New Mexico | $389 | $272 | $117 | $883 | $618 | $265 | 70% | 30% |
| New York | $610 | $506 | $104 | $1,477 | $1,099 | $378 | 76% | 24% |
| North Carolina | $449 | $433 | $15 | $951 | $462 | $489 | 62% | 38% |
| North Dakota | $427 | $427 | $0 | $1,029 | $1,029 | $0 | 100% | 0% |
| Ohio | $478 | $406 | $72 | $1,325 | $1,115 | $210 | 84% | 16% |
| Oklahoma | $439 | $641 | -$202 | $1,061 | $1,272 | -$211 | 125% | -25% |
| Oregon | $1,030 | $978 | $51 | $1,366 | $1,298 | $68 | 95% | 5% |
| Pennsylvania | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| Rhode Island | $589 | $471 | $118 | $1,650 | $1,320 | $330 | 80% | 20% |
| South Carolina | $408 | $311 | $98 | $851 | $616 | $235 | 73% | 27% |
| South Dakota | $496 | $496 | $0 | $675 | $493 | $183 | 85% | 15% |
| Tennessee | $615 | $494 | $120 | $1,337 | $1,078 | $259 | 81% | 19% |
| Texas | $469 | $469 | $0 | $1,018 | $744 | $275 | 83% | 17% |
| Utah | $402 | $366 | $37 | $1,023 | $930 | $93 | 91% | 9% |
| Vermont | $676 | $541 | $135 | $1,611 | $1,289 | $322 | 80% | 20% |
| Virginia | $504 | $450 | $54 | $1,166 | $1,017 | $150 | 88% | 12% |
| Washington | $536 | $459 | $77 | $1,187 | $1,008 | $179 | 85% | 15% |
| West Virginia | $473 | $368 | $106 | $980 | $683 | $297 | 71% | 29% |
| Wisconsin | $681 | $594 | $87 | $1,697 | $1,482 | $216 | 87% | 13% |
| Wyoming | $686 | $636 | $50 | $1,415 | $1,292 | $123 | 92% | 8% |
| United States | $570 | $502 | $68 | $1,233 | $1,004 | $230 | 84% | 16% |
| Note: "Due to rounding, the sum of employer and employee contributions may differ from total premium." Source: The Pew Charitable Trusts, "State Employee Health Plan Spending" | ||||||||
Healthcare policy in the 50 states
Click on a state below to read more about healthcare policy in that state.
See also
Footnotes
- ↑ 1.0 1.1 1.2 1.3 1.4 The Pew Charitable Trusts, "State Employee Health Plan Spending," August 2014
- ↑ Note: This text is quoted verbatim from the original source. Any inconsistencies are attributable to the original source.
- ↑ National Conference of State Legislatures, "State Employee Health Benefits," accessed July 20, 2015
