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Correct PEIA Co-Pay Injustice

Here in the Northern Panhandle, state lines don’t mean much. We cross them frequently into Ohio and Pennsylvania for a variety of purposes, including health care.

But the border does mean something in Charleston, where the Public Employees Insurance Agency is headquartered. What it means is that if those insured by the program seek health care out of state, they will pay more out of their own pockets than if they stayed in West Virginia.

Health insurance through the PEIA discriminates against those living in border counties — and there are a lot of those in our state. PEIA enrollees are subject to higher co-pays when they use out-of-state providers.

Members of a task force appointed by Gov. Jim Justice to look at ways to keep the PEIA on a secure financial footing discussed the issue during a meeting last week.

Changing the plan for out-of-state health care would be costly, PEIA Director Ted Cheatham told task force members. He estimated the price tag would be about $22.4 million a year.

No one wants to increase PEIA costs needlessly, of course. They already are an enormous burden — on taxpayers who may have to fork over $675 million for the purpose next year as well as for those who rely on the PEIA for health care insurance.

But higher co-pays for out-of-state providers are, in two words, unfair and unrealistic. Would a retiree on PEIA living in, say, Putnam County be charged more for crossing the county line to get specialized health care in Charleston? Of course not. That would be absurd.

So why should it cost more for a retiree to drive across the Fort Henry Bridge to get care in Ohio?

Surely some means of correcting the problem can be found. PEIA officials and, if necessary, Justice and state legislators should take care of it.

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