I can say with some authority that not everything in state government works with complete efficiency, since my phone tends to ring when readers find things are less than optimal.
That being said, one program that participants universally regard as being top shelf is the PEIA Medicare Advantage plan, the Medicare supplemental benefits program that covers about 52,000 retired public employees and school personnel and their spouses.
PEIA awarded the contract to Humana in 2015, and during that time participants have seen their premiums drop by 10%, while in the past year, Humana refunded more than $30 million to PEIA through gainshare and reduced costs as the pandemic cut down on elective surgeries and procedures.
The vast majority of PEIA Medicare Advantage Plan participants are happy with their coverage, and I can assure you that if it were otherwise, we would have heard about it, because senior citizens are not shy about expressing dissatisfaction, and I can say that because I am becoming one.
The contract with Humana is for five years, with options for two one-year renewals.
The contract runs on calendar years, so when the PEIA Finance Board met virtually last October, the assumption was that Executive Director Ted Cheatham would recommend exercising the renewal option, rather than try to bid out a $100 million-a-year contract in the midst of a pandemic — a pandemic that remains so deadly Gov. Jim Justice still cannot safely reopen his press briefings to in-person media.
However, Cheatham instead announced PEIA would go out to bid for a new Medicare Advantage plan contract, with a Feb. 26 opening of requests for proposals, with plans to award the contract, which would go into effect Jan. 1, 2022, at roughly about this time of year.
At the time, Cheatham sounded almost apologetic about putting the contract out to bid, saying of the Humana coverage, “There’s no financial issues. There’s no quality issues. There’s no service issues.”
As for concerns about imposing changes in coverage and benefits on a population that is particularly adverse to change, and I can say that because I am becoming part of that population, Cheatham noted that such adversity is commonplace for private sector employees and retirees.
“Everybody working for a private employer has changed plans at some point,” he said.
Another twist was, instead of doing the request-for-proposal process in-house, PEIA contracted with Michael Reed of Gabriel, Roeder, Smith and Co. Health and Welfare Consulting of Irving, Texas, to oversee the bidding process.
On May 14, PEIA paid the firm $18,000 for overseeing the Advantage Plan request-for-proposal process.
Cheatham, indeed, recommended a contract extension but was overruled by the governor’s office.
Now, it might be that Justice was acting out of an abundance of caution or out of a commitment to governmental transparency.
Or, as some speculate, it might have had something to do with the fact that Justice’s personal lobbyist (for The Greenbrier) and political advisor, and consultant on his 2020 reelection campaign, Larry Puccio, also lobbies for a rival managed health care and insurance company, United Healthcare Services.
United Healthcare, in fact, bid on the PEIA Advantage Plan contract, along with Humana, Aetna, and Centene.
Lo and behold, after all was said and done, and perhaps not surprisingly, Humana scored best on the re-bid, and is in the process of finalizing a new contract with PEIA, according to Department of Administration spokeswoman Samantha Knapp.
Again, one can argue whether Justice intervened out of an abundance of caution and in the name of transparency, or was attempting to steer a lucrative state contract to a vendor that employs his personal lobbyist and political confidant. You be the judge.
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Kudos to legislative leadership for seeing the error of their ways and restoring legislative interim meetings to three days a month, after three years of truncated, day-and-a-half interims (and a suspension of interim meetings last year during the pandemic).
The purpose of interim meetings is valid and sensible: Given that it’s unreasonable to expect a citizen Legislature to get up to speed on issues and problems facing the state in the course of a 60-day regular session, interim meetings are designed to provide a more thorough review of pending issues during the Legislature’s off-season.
However, by cutting monthly meeting times in half and taking many months off entirely, the Legislature hamstrung itself in terms of preparation for legislative sessions.
Instead of an interim committee being able to meet seven or eight times over the course of the year to get up to speed on a particular issue, the truncated schedule reduced that to one or two opportunities leading up to the next regular session.
Lacking the opportunity to do their homework on the issues, legislators over the past five years have acted on gut feelings, hunches and hearsay and frequently have opted to do the bidding of right wing organizations like the American Legislative Exchange Council that conveniently provide pre-prepared copies of legislation.
Interim meetings aren’t quite back to full speed this year. Legislators will take two months off this summer instead of the traditional one-month vacation.
Still, the current schedule provides legislators with some 250 hours of interim meetings between now and the 2022 regular session, a major improvement in the amount of time they have to do their homework for the session.
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One topic that undoubtedly should be first and foremost on the interims agenda: The 3.2% state population loss, as revealed by the 2020 U.S. Census, a population loss that has accelerated under Republican control of the Legislature and state government.
The Legislature needs to call in the experts who can explain why the population drain is happening (as noted previously, historically, state population losses have coincided with sharp declines in coal mining employment, which fails to explain the current downturn since coal is no longer a major employer in the state) and what, if anything can be done to reverse the decline.
No hunches, no surmises, no absurd political rhetoric, just facts and data.
The current leadership has acted on hunches before to great detriment to the state.
No, we weren’t able to build five schools for the price of three with the repeal of prevailing wage.
No, all those companies that supposedly wouldn’t locate in West Virginia if they had to operate union shops didn’t come rushing into the state when the Legislature enacted right-to-work legislation.
Reader Scott Bickel of Canvas wrote me with an interesting idea for addressing population loss.
He proposes a comprehensive survey of the target audiences of current residents and prospective residents, having them select, in order, the 10 most important factors in determining where to live, as well as the five factors that would make them most likely to avoid or leave the state.
“It might surprise you where some of the overlaps will be,” he wrote. “At least we would know.”
Not a bad idea, effectively doing market research on prospective residents. At least it would be more reality based than such nonsense as claiming that 400,000 folks will pour into the state if we repeal our income tax.
We can be assured that legislative leadership will not address the issue of population loss during interims, since such study likely would reveal they are a contributing factor in the state’s decline.
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Finally, we know Justice is a narcissist, and that was on clear display Thursday when he announced a “big, big” prize lottery as an incentive for state residents to get vaccinated.
That comes just weeks after he was incredulous about the idea of offering incentives to the vaccine hesitant, saying at his April 18 briefing, “Should we be paying people to get vaccinated? Really? Should you pay someone in order to try to save their life?”
What caused the change of heart? Justice conceded Thursday the West Virginia vaccine lottery is emulating big dollar vaccine lotteries in Ohio and other states, but not necessarily because those lotteries are resulting in spikes in vaccination rates (which they appear to be doing).
No, according to his statements Thursday, Justice’s rationale for launching the vaccination lottery is because he’s jealous of the national publicity that Ohio and Ohio Gov. Mike DeWine are attracting with their lottery.
“We’re not going to let a state like Ohio get ahead of us,” Justice said during the early evening briefing, a briefing delayed so he could play golf by day at his Greenbrier resort. “They’ve never been ahead of us.”
(Of course, that’s a patently absurd statement, since there are any number of categories where Ohio is ahead of West Virginia, but I threw out one: According to the Centers for Disease Control, Ohio ranks 26th in the U.S. in percentage of population that is fully vaccinated. West Virginia is 40th.)
Clearly, Justice is not acting out of concern for the people, or because vaccination rates in the state are lagging as we have large pockets of the vaccine hesitant or straight out anti-vaxxers.
No, Big Jim is unhappy that his moment in the national spotlight has passed, and governors like DeWine are the current national media darlings.
Like virtually all his initiatives, Justice has jumped into the vaccine lottery game without vetting exactly how it is to operate, which means we can expect goof-ups, setbacks and complications as Justice and company use trial and error to put the program together on the fly.
We can also be assured whenever the prizes are awarded, Justice will be there, out front and center, because no matter what the matter may be, it’s always all about Big Jim.
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