The Michigan Education Special Services
Association reported $268.8 million in net assets to the Michigan
Office of Financial and Insurance Services in its most recent financial report.
MESSA calls this accumulated revenue "Net Assets Available for Benefits in
Excess of Benefit Obligations." Sounds good! But it’s actually profit, or "net
gain" that comes from overcharging schools for benefit plans.
MESSA is controlled by the Michigan Education Association,
the labor union that represents teachers and other school employees. MESSA is
not an insurance company. It’s a third-party administrator that sells insurance
packages to school districts. Blue Cross Blue Shield of Michigan is the
insurance carrier for all MESSA health plans except for the benefits that exceed
BCBSM’s operating authority. The extraordinary benefits not covered by BCBSM are
insured by BCS Life, a for-profit company partially owned by BCBSM.
MESSA’s accumulated assets of $268.8 million includes $150
million gained in just one year and excludes the $131 million of revenue gain
that MESSA used to subsidize rates a few years ago. The $268.8 million is excess
charges by MESSA to school districts. This represents more than $2,900 per
employee covered by a MESSA health plan and the $150 million represents about
$1,600 per covered employee. This is all taxpayer money — money that could have
been used by school districts to enhance public school budgets and improve
education for children.
There are alternatives to MESSA, given the recent legislation
adopted by the Michigan Legislature as part of the budget wrangling this year.
The new law will make it easier for schools to form insurance pools and ask for
competitive bids for health plans. It also will require MESSA to release the
aggregate claims history that it holds on each individual school district. Most
insurance administrators would want to review that data before making a bid, but
MESSA routinely refuses to release the numbers.
One thing every school district could do is name itself the
policyholder of the health plans they provide to their employees. Right now,
MESSA is almost always the policyholder for the health plans it sells to school
districts. Being the policyholder gives MESSA full control over the plan
benefits and exclusive rights to the claims history data. Even though state law
provides that naming the policyholder is not a matter of collective bargaining,
most school district boards have unwittingly ceded this management right to
MESSA and the teachers union. School districts should become the policyholder
for all health plans that cover their employees and then solicit health plan
quotes from qualified health plan administrators.
Beyond MESSA, the larger problem is that Blue Cross and Blue
Shield of Michigan has a virtual monopoly on public school employee health care
in Michigan, selling its plans directly to districts or through MESSA. BCBSM is
governed by Public Act 350 as a "nonprofit health care corporation." The act
exempts it from state taxes in return for requiring BCBSM to insure anyone who
can’t get coverage elsewhere.
BCBSM’s total annual premium from public schools is over $2
billion, including $1.2 billion from MESSA. It makes a substantial "profit" on
those premiums. Yes, BCBSM is a "nonprofit" corporation by law, but maybe it
would be good to ask how many BCBSM executives are paid in excess of $500,000
each year? BCBSM is the last of the state-controlled Blues plans; many Blues in
other states have become mutual companies or stock companies. BCBSM should do
the same.
The real answer to reducing the cost of health care for
teachers and school employees is for school boards to utilize the advantages of
competition. When health insurance administrators compete for business, costs
come down. This does not mean that school employees will not have responsible
coverage. It means that school boards will have the funds to advance education
for children. The money is there. It just takes courage and determination by
school boards and administrators to redirect the dollars.
Frank Webster is the former executive director of the Michigan Education Special Services Association and a health care cost management consultant.