BY MALIA ZIMMERMAN - HONOLULU — A new report from State Budget Solutions, a national nonprofit organization focusing on states’ fiscal responsibility, warns it’s time for newly elected state officials in Hawaii and throughout the country to address unfunded liabilities in the retirement system.
The share of Hawaii’s $30-billion unfunded liability per resident is $21,852, the seventh highest in the nation, said Joe Luppino-Esposito, the study’s author.
He said Hawaii’s Employees’ Retirement System is only 29 percent funded because the state isn’t putting enough money into the system to pay future promised benefits. The unfunded liability amounts to 41 percent of the state’s gross domestic product.
State officials paint a different — if still grim — picture, showing the pension system as 60 percent funded.
The translation in real dollars is $8.5 billion. That’s a major discrepancy from the SBS $30 billion estimate.
The main difference, Luppino-Esposito said, is the discount rate used. That’s the rate that determines how much money is needed today to have enough revenues in the future to meet obligations to retirees.
Hawaii uses a 7.75 percent discount rate, assuming the plan will average 7.75 percent investment growth over time, a number Luppino-Esposito said “is far too high.”
“Hawaii should use a risk-free rate instead, ensuring that state employees will actually get the pension they were promised,” Luppino-Esposito said.
Hawaii is far from alone. The SBS report, which reviewed 250 plans, documents state governments are in a $4.7 trillion hole. Liabilities have increased roughly $600 billion since last year. The average state public pension plan is only 36 percent funded, the report said.
Wes Machida, executive director of Hawaii’s Employees’ Retirement System, acknowledged there are some elements in the study to which the state should pay attention.
“There are concerns about employers being able to make those kinds of contributions,” Machida said. The “employers” he is referring to are state and local governments.
“At some point down the road, this will likely be an issue for Hawaii. The requirements will be so high as to outgrow what is available in the general fund. That is a possibility if we don’t do something to help with the situation,” Machida said.
Pension reforms implemented by the Legislature in the past four years should help, he said.
Machida and the Employees’ Retirement System Board of Trustees hope Hawaii’s newly elected governor, David Ige, will push additional reforms to further reduce benefits for new hires. The next legislative session begins in January.
Lawmakers in 2011 and 2012 approved legislation that reduced retirement benefits for new state employees who entered the system as of June 30, 2012. Another change in 2012 prevents workers from accruing benefits from overtime, bonuses, lump sum salary and allowances.
In 2011, legislation increased the employer and employee contribution rates. Employees pay between 6 to 14.2 percent of their pay into the fund. Employer contributions are steadily increasing until 2016, when the contribution rate will stabilize at 17 percent of pay for all employees except police officers and firefighters. Those agencies will contribute 25 percent of their employees’ pay.
Other changes include doubling from five to 10 the number of years it takes to become vested in the system.
Machida said the Board of Trustees lowered the anticipated rate of return for next year on investments. The rate will be reduced gradually over the next three years to 7.5 percent, and will be reviewed annually by the board, Machida said.
According to state figures, the retirement fund is at $13.9 billion as of Sept. 30, but because markets have grown, Machida said the fund is probably around $14 billion now.
Another $8.5 billion is needed to cover unfunded liabilities or future payments owed to the more than 115,000 people in the system, including all retirement income, death and termination benefits, but the state won’t be able to cover that amount for decades.
To put it in perspective, the state’s biennium operating and capital budgets are $24 billion during the next two fiscal years.
The state’s financial plan will pay off the retirement system’s unfunded liabilities within 26 years.
“The most important thing is we need to monitor what is going on with the fund and how the investment markets are impacting us. That also includes how the membership has changed and what their retirement needs are,” Machida said.
“If more people start to retire earlier, we will need more payouts, and that will require us to liquidate more funds. If members start living longer, we will need more benefit payouts. There are many different areas to monitor to make sure the fund is properly funded,” Machida added.
Between 2,000 to 2,500 state and county employees retire each year in Hawaii, adding to the $1.1 billion annual payout already made to 67,000 retirees in the plan, which has additional challenges not necessarily encountered in the rest of the country. The average life expectancy for members in Hawaii is 82 to 83 years of age, much greater than the national average, Machida said.Use Facebook to Comment on this Post
By Jasmine Greenamyer - Colon cancer will claim more than 50,000 American lives this year. One in 20 people will be diagnosed at some point in their lives.
Thanks to better screening and new treatments, the death rate from colon cancer has been dropping for more than 20 years. But even the best screening and treatment can't help those unable to afford health care.
The Affordable Care Act was designed to help make sure patients could receive the care they need. But it's failing America's most vulnerable patients. Congress must make sure the Affordable Care Act lives up to its name and enables people to access the health coverage they need.
When Congress passed healthcare reform, one key protection for patients was a requirement that insurers cover a minimum set of "essential" benefits. Another protection banned insurers from discriminating based on health status. Despite these protections, many of the insurers offering plans on the new insurance exchanges are shifting the cost burden of medications to patients.
Put simply, Congressional intent is being ignored.
That's why lawmakers must step in to make sure the Department of Health and Human Services updates its essential health benefits rule. Congress must also call on HHS to provide guidance to states that are being asked to assess whether exchange plans are discriminating against certain patients.
All exchange plans are required by law to cover prescription drugs. Each insurer maintains a list of prescription drugs -- a formulary -- that specifies the drugs it will cover. But most formularies have four or more "tiers" of coverage that place increasing cost-sharing obligations on patients. The surprise comes when you develop a condition whose medications fall into the top tier.
The first tier, usually for the most commonly prescribed medications, might include a modest copay of, say $20. But the highest tier typically involves co-insurance, in which the patient is responsible for a fixed percentage of the cost of a drug. The coinsurance percentage can run to 40 percent or more for drugs that can costs thousands of dollars.
This means that patients can get stuck with huge bills. The impact falls disproportionately on patients with serious conditions that require expensive medications, such as cancer, multiple sclerosis, and HIV/AIDS.
Indeed, a recent study by Avalere Health analyzed 123 mid-level exchange plans and found that more than 60 percent place all medication for cancer and other life-threatening conditions on the highest cost-sharing tier.
These formularies seem discriminatory, but HHS hasn't stepped in to crack down on insurers. Congress must call on federal officials to make clear that discriminatory coverage is prohibited.
Such high out-of-pocket drug costs threaten to put necessary treatments out of reach for the patients who need them most. Patients are left with little choice but to deplete their savings or retirement funds, declare bankruptcy, or skip or refuse treatments.
Researchers at Duke University Medical Center surveyed cancer patients to learn how they coped with these costs. Nearly half described the financial burden as "significant" or "catastrophic." Forty-six percent had to cut back on basic needs such as groceries.
The greater the cost-sharing, the more likely a patient will postpone or forgo medication. According to a study by University of North Carolina researchers, patients with higher co-payments were 70 percent more likely to stop taking their cancer treatment and 42 percent more likely to skip doses.
This is a serious, life-threatening problem. Skipping treatments significantly increases the risk of relapse. Missing even just 15 percent of a prescribed dose can lead to a recurrence of the cancer.
Getting a colon cancer diagnosis is bad enough without adding exorbitant out-of-pocket costs for treatment. If the new health law is to live up to its promise of affordable care, Congress must create a solution and help people get the care they need and deserve.
Jasmine Greenamyer is the Chief Operating Officer of the Colon Cancer Alliance.
HONOLULU – Attorney General David M. Louie and Director of Human Services Patricia McManaman jointly announced today that a decision by the U.S. Supreme Court validates the state’s authority to determine the level of health care coverage provided to noncitizens who are ineligible for federal Medicaid. The high court’s decision also confirms that the state did not discriminate when it exercised that authority in 2010.
On Monday, Nov.3, 2014, the U.S. Supreme Court rejected plaintiffs’ appeal in Korab v. McManaman, which leaves intact the Ninth Circuit Court of Appeals decision in favor of the state. That decision found the state was not required provide state-funded medical assistance benefits to noncitizens after the federal Medicaid program excluded them.
The federal Welfare Reform Act of 1996 eliminated federal health care funding for many noncitizens, including migrants from Palau, the Republic of the Marshall Islands, and the Federated States of Micronesia.These island nations have a Compact of Free Association (COFA) with the United States that allows their citizens to live and work in the U.S. Even after federal funds were not available, the state continued state-funded medical assistance benefits for COFA residents. The benefits provided were essentially the same as citizens received under federal Medicaid until 2010 when the state sought to implement a more limited program for noncitizens. Plaintiffs in the Korab case are noncitizen COFA residents whose benefits would have been reduced under the 2010 program. Federal District Court Judge Michael Seabright sided with the plaintiffs and issued an injunction blocking implementation of the program in 2010.
The Ninth Circuit Court of Appeals reversed the decision of the District Court earlier this year, and held that Hawaii is not required to replace the federally-funded health care benefits that were lost under the federal Welfare Reform Act. The state has remained subject to the injunction pending the decision by the U.S. Supreme Court, and expects the Federal District Court to dissolve the injunction shortly.
According to Attorney General Louie, “This decision is important because it confirms that the state's actions were not discriminatory. But it is also important to know that the state intends to continue providing significant assistance to these individuals.”
“My administration is committed to the principle that all Hawaii residents should have health insurance,” said Gov. Neil Abercrombie. “The state will strive to ensure that our neediest residents, including noncitizens, have access to quality health care coverage.”
According to Director McManaman, “The state’s plan going forward includes a program that provides Medicaid-like coverage to our neediest aged, blind, and disabled noncitizens. Coverage for children and pregnant adults will remain unchanged. The plan also includes a transition period for other non-pregnant adult noncitizens to obtain health insurance through the Hawaii Health Connector, and a state-funded program to help these very low-income noncitizens pay their share of their health insurance premiums. This ensures that needy noncitizens who are ineligible for Medicaid still have access to quality, affordable health insurance.”
Adult noncitizens who are not pregnant, and are not aged, blind, or disabled, and who were eligible beneficiaries under the injunction, will continue to receive their current level of benefits until the new programs are implemented. Those beneficiaries will soon receive a notice in the mail explaining the changes, and they should contact the Department of Human Services at the number provided on the notice if they have any questions.