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The less you make, the more you pay

It’s expensive to be poor, especially when it comes to health care costs. Hold a good, solid, full-time, upper-income job with good health care benefits, and such things as preventive care and earlier physician intervention are practical things. Hold the other kind of job, part-time with lower pay and benefits, and most likely you’ll be stuck putting off health care until time has come for the emergency room – which is just about the most expensive kind of health care around.

You can see why some of this develops (and it is an increasingly common approach in both private and government organizations), and there is some reason behind at least some of it. Give full benefits to a part-time employee who at least in theory might be able to work part-time somewhere else too, and – in the zero-sum game that is personnel budgeting – you’re limiting what you can provide a full-timer. Except, of course, that in this economic environment, what’s really happening is that the part-timers are being shut out of health insurance and, until emergency room time, health care altogether.

Hence the controversy in Idaho, outlined in an Idaho Statesman story today, about a change in state personnel policy requiring, in essence, those state employees who earn the least will have to pay the most for health insurance and related benefits, likely soon kicking them out of the system.

The story clarifies some of this in the case of state employee Zack Gonzales:

Gonzales works 20 hours to 40 hours a week at the Idaho State Emergency Medical Service Communications Center in Meridian.

He pays about $30 a month for health insurance. That’s what all qualifying state workers insuring only themselves – not family members – now contribute for the health-plan option Gonzales has, whether they’re full-time or part-time. But beginning this fall, his share of the premium will rise to $302.50, a 900 percent increase, or most of one of the two paychecks he gets from the state every month.

Gonzales and his companion rely on Gonzales’ check for the mortgage on their home. So Gonzales, 23, will choose the mortgage over health insurance. That means medicine he pays only a few dollars for now will cost him $200 a month.

We sent an inquiry about this policy shift to the governor’s office a couple of weeks back. Never got a reply.

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