WP: Gov. Kaine: state employee health plan to cover same-sex partners

[Stadium-Armory]

I like that this doesn't get tangled up in the prickly subject of "marriage", rather it addresses the problem from an "equal protection under the law" standpoint. But I don't like how open ended it is in terms of who can be covered, and I don't quite get how it will be paid for.

http://www.washingtonpost.com/wp-dyn/content/article/2009/12/03/AR2009120304329.html

By Anita Kumar

Washington Post Staff Writer

Friday, December 4, 2009

RICHMOND -- Virginia Gov. Timothy M. Kaine has directed his staff to begin putting into effect a proposal that would allow same-sex partners to be covered under the state's employee health plan.

The incoming governor, Robert F. McDonnell ®, who has sparred with Kaine (D) on gay rights issues, expressed concern Thursday about the potential cost of the proposal but did not criticize what is expected to be a controversial one.

"My first question is, what [is] the cost to the state by expanding those policies?" McDonnell said at a news conference at the state Capitol. "I am all for using business -- public and private -- to expand health-care coverage. . . . But what I don't know is, what is the cost that has to be borne by the state government versus the individual new subscriber?"

The proposal, which comes weeks before Kaine leaves office, would expand benefits to qualified adults who live in the same house as an insured state employee. Those adults could include heterosexual and homosexual partners, roommates, children and other family members, such as an aunt or grandfather.

Sara Wilson, director of the Virginia Department of Human Resource Management, said officials hope to offer the expanded benefit at no additional expense to the state because employees would be required to pay the entire cost. She said that state officials have been discussing the proposal for months but that she was not directed until mid-November to begin implementing the change.

Wilson said that a change of this magnitude would take about 18 months to implement, well after Kaine completes his four-year term Jan. 16. That would leave McDonnell to decide whether to continue the program.

Wilson referred questions on timing to the governor. Kaine spokeswoman Lynda Tran said that he "will continue to make proposals and take actions relevant to the welfare of the Commonwealth until he leaves office."

House Majority Leader H. Morgan Griffith (R-Salem) said that Kaine, who serves as chairman of the Democratic National Committee, is a "political animal" and called his timing suspect.

"He gets to throw a bone to his base and then create a land mine for the incoming administration," Griffith said. "It may be totally innocent, but to change a policy in the last month of administration calls it into question."

Kaine and McDonnell clashed on gay rights in 2006 when McDonnell, then the state attorney general, advised Kaine that he had overstepped his constitutional authority when he outlawed bias against gays in state hiring.

Tran said the proposal is "in line with actions [Kaine] has taken throughout his time in office to expand health-care coverage for Virginians and generally improve health outcomes."

Eighteen other states provide benefits to adults other than spouses, and 10 provide benefits to domestic partners with no distinction between couples of the same or opposite sex, Wilson said.

In the Washington region, Maryland offers benefits to same-sex partners; the District, to domestic partners.

At the news conference, McDonnell also announced his first administration appointments. He named Chief Deputy Attorney General Martin Kent as chief of staff, Deputy Attorney General Marla Decker as secretary of public safety, lobbyist Eric Finkbeiner as senior adviser for policy and spokesman Tucker Martin as communications director.

McDonnell said he asked Kaine's finance secretary, Ric Brown, to continue to serve for an undetermined period while the state wrestles with a budget shortfall.

[Prosperity]

well if people are going to push for separate but equal then they should really try to make it as equal as possible

[skinfan133]

This is kind of a step in the right direction, if not in the wrong order. I don't see how this is technically legal since there is no legal definition in Virginia at the moment concerning same-sex partners. A step in the right direction would be for Virginia to codify civil unions for same-sex couples. I think this could be done despite our ill-written Constitutional amendment on marriage.

personally, in my own Virginian universe, we would repeal our amendment on marriage and institute a new constitutional provision in which there is no definition for marriage and a civil union can be granted to any couple. Leave marriage up to the Churches!

[Popeman38]

So naturally this will be applied to live-in girlfriends and boyfriends, right?

[Stadium-Armory]

So naturally this will be applied to live-in girlfriends and boyfriends, right?

I think so. And that's what confuses me about it. Very open ended like that.

[TimmySmith]

So naturally this will be applied to live-in girlfriends and boyfriends, right?

It appears it is going to apply to anyone who claims to live under your roof.

[GhostofSparta]

It appears it is going to apply to anyone who claims to live under your roof.

There's gonna be lots of late-20/early-30 year old unemployed (probably single) people moving back in with mom and dad if that's the case.

[Brad_Edwards_Fan]

There's gonna be lots of late-20/early-30 year old unemployed (probably single) people moving back in with mom and dad if that's the case.

Or simply friends helping each other out while one is unemployed. Not that thiy couldnt do the same thing with a "fake" marriage, but if just living together would count, that makes things much easier

[Larry]

Don't necessarily object to the plan. (Since, supposedly, the partner will be paying 100% of the cost.)

OTOH, the whole thing of having the Governor do this by Executive Order, after he loses the election, just seems so . . . George Bush.

[ljs]

My gf's work allows same sex partner benefits, as well as hetero/non married couple benefits, but there are rules. You have to sign a declaration saying you are in deed in a romantic relationship and that you have lived together for at least 12 months (The paper also says you can be charged with a crime if you lie about it).

So this year during open enrollment, she added me to her dental plan, that way I have dual dental coverage. I didn't feel the need to pay the $100 or so more to add me to her medical plan, mine is decent enough.

I'll add that my company does not allow same sex partner benefits, even though we use the same insurance company as my gf's employer. However, they do audits on the married folks, where everyone who has a spouse signed up had to fax a copy of their marriage certificate to prove the person was their spouse.

[twa]

It's a interesting concept,but what are the effects on others rates?

Would seem a verification nightmare,but I like the idea if it does not adversely effect others rates.

Where's Kilmer or SS?...need a informed opinion.

[SnyderShrugged]

It's a interesting concept,but what are the effects on others rates?

Would seem a verification nightmare,but I like the idea if it does not adversely effect others rates.

Where's Kilmer or SS?...need a informed opinion.

Honestly, I think it has potential to bring rates down, though probably nominally.

It would possibly have the effect of putting more healthy people into the risk pool and spread out the risk for underwriting.

LJS is right too, there are verification steps that are done for each policy. Believe it or not, that verification is more to verify that the significant other isnt elligible for their own policy. There is a great deal of fraud in recent years where both spouses carry policies and double dip their claims.

[twa]

Why is double dipping so bad...they collect two premiums.

[ljs]

LJS is right too, there are verification steps that are done for each policy. Believe it or not, that verification is more to verify that the significant other isnt elligible for their own policy. There is a great deal of fraud in recent years where both spouses carry policies and double dip their claims.

can you clarify the bolded part? For example, now that I'm on my gf's dental plan, and I have my own plan- I thought that when I go to the dentist, I can use both coverages. Are you saying that I shouldn't have been added to her dental coverage b/c I already have my own? I did it that way on purpose this year b/c I have some dental work to be done, and was hoping that by getting more insurance, I would save money in the long run.

[SnyderShrugged]

Why is double dipping so bad...they collect two premiums.

Bear in mind, it's defrauding the insurance company and even their employers.

Yes, two premiums are collected. But the employers are subsidizing those premiums. Also, one of the two insurance companies is paying a claim that is already paid by another company for the same procedure.

End result, higher premiums for everyone.

[SnyderShrugged]

can you clarify the bolded part? For example, now that I'm on my gf's dental plan, and I have my own plan- I thought that when I go to the dentist, I can use both coverages. Are you saying that I shouldn't have been added to her dental coverage b/c I already have my own? I did it that way on purpose this year b/c I have some dental work to be done, and was hoping that by getting more insurance, I would save money in the long run.

It's really two concerns.

The first is that it's probably OK as long as only one claim is filed with one company. The second would depend on your state laws and the policies of each of your insurance companies. Usually, you will have to declare if there is dual coverage at the onset of the plan year.

I'd just double check your policies to make sure that cant come back after one of you down the road. They often catch these things with audits in the spring after most traditional open enrollment periods are concluded.

[ljs]

SS- k Thanks. Never realized that piece of it, thought it was legit way to get more coverage. I wonder if we check into this and find out we can't do this, hopefully they drop me and save me the $5 a month it costs.

[SnyderShrugged]

SS- k Thanks. Never realized that piece of it, thought it was legit way to get more coverage. I wonder if we check into this and find out we can't do this, hopefully they drop me and save me the $5 a month it costs.

Do you remember if you had to sign anything saying that you didnt have dual coverage available? Usually, they are pretty strict on that if its a concern with your company and/or state.

You probably are OK, but check just in case.

I'd hate for you to have to arrest yourself!

[twa]

Bear in mind, it's defrauding the insurance company and even their employers.

Yes, two premiums are collected. But the employers are subsidizing those premiums. Also, one of the two insurance companies is paying a claim that is already paid by another company for the same procedure.

End result, higher premiums for everyone.

Sorry I don't understand...you are saying either they are charging too low of rates or the employer is giving excess benefits against their will?:evilg:

If that raises rates wouldn't adding more to the pool do the same thing?

What am I missing?

[SnyderShrugged]

Sorry I don't understand...you are saying either they are charging too low of rates or the employer is giving excess benefits against their will?:evilg:

If that raises rates wouldn't adding more to the pool do the same thing?

What am I missing?

LOL, I'll try to simplify...

One of the two claims is fraudulent. That is what raises rates.

The other issue, the adding more people to the risk pool has a rate lowering effect (at least in theory).

[Larry]

Bear in mind, it's defrauding the insurance company and even their employers.

Yes, two premiums are collected. But the employers are subsidizing those premiums. Also, one of the two insurance companies is paying a claim that is already paid by another company for the same procedure.

End result, higher premiums for everyone.

I never thought of it before I read twa's post, but I think he's got a point.

OK, so in theory, the insurance industry pays out twice as much money as they should.

They also collect twice as much money as they should.

Since, in theory, they collect more than they pay out (they aren't in the charity business), it would appear to me that the insurance companies would be making double the profit under this plan.

(Now, the employers are paying out twice as much as they should be, and they aren't getting anything out of the deal. I could see why they would object.)

Only way I could see this hurting the insurance companies is if there's another layer of fraud in the picture:

1) ljs buys insurance from two companies.

2) She pays double premiums, and gets double payment.

3) Because she's getting double payment, this means that she actually makes money every time she uses her insurance.

4) Because of this, she decides to go and see the doctor a lot, and gets a lot of other medical procedures that she doesn't need. (After all, the more procedures she gets, the more money she makes.)

5) The companies are now collecting twice, and they're paying twice, but they're paying double for an inflated number of treatments.

Only trouble I have with that picture is that I have trouble imagining somebody deliberately getting unneeded dental work done, simply for the money.

[twa]

LOL, I'll try to simplify...

One of the two claims is fraudulent. That is what raises rates.

The other issue, the adding more people to the risk pool has a rate lowering effect (at least in theory).

Oh I agree it is legally fraud,but the rate part makes no sense.

How is the extra rate paid by the double dipper different than the rate added by a new dependent?(such as in this program)

[SnyderShrugged]

Oh I agree it is legally fraud,but the rate part makes no sense.

How is the extra rate paid by the double dipper different than the rate added by a new dependent?(such as in this program)

because two claims are paid for one procedure.

[Larry]

because two claims are paid for one procedure.

And two premiums are paid.

And the premiums are more than the payments. (That's how the insurance company makes money.)

[SnyderShrugged]

I never thought of it before I read twa's post, but I think he's got a point.

OK, so in theory, the insurance industry pays out twice as much money as they should.

They also collect twice as much money as they should.

Since, in theory, they collect more than they pay out (they aren't in the charity business), it would appear to me that the insurance companies would be making double the profit under this plan.

(Now, the employers are paying out twice as much as they should be, and they aren't getting anything out of the deal. I could see why they would object.)

Only way I could see this hurting the insurance companies is if there's another layer of fraud in the picture:

1) ljs buys insurance from two companies.

2) She pays double premiums, and gets double payment.

3) Because she's getting double payment, this means that she actually makes money every time she uses her insurance.

4) Because of this, she decides to go and see the doctor a lot, and gets a lot of other medical procedures that she doesn't need. (After all, the more procedures she gets, the more money she makes.)

5) The companies are now collecting twice, and they're paying twice, but they're paying double for an inflated number of treatments.

Only trouble I have with that picture is that I have trouble imagining somebody deliberately getting unneeded dental work done, simply for the money.

I think you guys might be misunderstanding the nature of premiums a little. Premiums for one participating member of an insurance company most likely wont pay in full for that individuals claims (think catastrophic claims). If it were a premium = claims equation, premiums would be many times higher than they are.

The essential risk in health insurance is often in aggregation. If one event can cause losses to numerous policyholders of the same insurer, the ability of that insurer to issue policies becomes constrained, not by factors surrounding the individual characteristics of a given policyholder, but by the factors surrounding the sum of all policyholders exposed.

The model for aggregation is to have multiple premiums that weigh against the potential risk of future claims, then the claims are spread out over many people over a long time.

(I hope this makes sense! I just reread and I am not sure if I explained clearly)