Thursday, November 08, 2007

What the General Convention Has Done (and Might Do): Clergy Healthcare Coverage

There is a lot of attention these days on diocesan conventions, driven mostly by concerns about dissenting dioceses taking actions that further divisions in the Church. There are comments about other conventions, of course; and most of those are relatively quiet, and frequently pragmatic. Ours was; which is why I was able to draft my most recent posts while there.

One pragmatic topic that came up at our Diocesan Convention was the cost of health insurance for clergy and lay professionals. Costs have risen, just as for other professionals and staff. Churches have always struggled financially, and costs of clergy benefits have always been important expenses.

One factor in costs for coverage has been the fragmented way in which contracts have been negotiated. Basically, while negotiation is managed by the Episcopal Church Medical Trust of the Church Pension Group, it's managed on a diocese-by-diocese basis. As a result, each diocese is its own actuarial pool. That means that there are significant differences from one diocese to another. Large dioceses with many clergy are able to negotiate better deals, and so better costs, than smaller dioceses. More urban dioceses may have more and better options than largely rural dioceses. The result is an uneven patchwork of coverage and costs for clergy and lay professionals. Some years ago I listened as a colleague from another diocese told me his diocesan plan wouldn't cover him in my Episcopal hospital.

In response to these concerns, General Convention in 2006 passed Resolution A147, “Study the Costs and Issues of Healthcare Benefits for All Clergy:”

Resolved, That the 75th General Convention endorse the Church Pension Group’s proposal to conduct a church-wide study of the costs and issues surrounding the provision of healthcare benefits to all clergy and lay employees serving churches, dioceses and other church institutions and to report their findings to the 76th General Convention; and be it further

Resolved, That all dioceses, parishes and other church institutions are urged to cooperate with the conduct of this study by responding to requests for data regarding employee census and healthcare costs; and be it further

Resolved, That this study will include an analysis of the potential for a mandated denominational healthcare benefits program and other viable alternatives, culminating in a recommended solution and an actionable implementation plan.

There are two interesting aspects of this resolution. The first is in the first paragraph: the sheer breadth and scope of the study. This is not simply a statistical overview, but is instead a thorough review with which all institutions of the church are “urged to cooperate.” This should give shape and form to the patchwork we already know is there. Statistical review has its value, and anecdotal evidence is helpful; but this will give the most detailed picture of the current situation, including the current disparities, and perhaps some unexpected opportunities.

Which brings us to the second interesting aspect of the resolution: the requirement of a meaningful result. The study is to include analysis, recommendations, and a plan for “a mandated denominational healthcare benefits program [or] other viable alternatives.” The point is to include all clergy and lay employees. This would, of course, create in the Episcopal Church the largest possible actuarial pool. Conceivably this would provide the Episcopal Church Medical Trust with the best foundation on which to negotiate for coverage.

Now, such a plan certainly would not make everybody happy. In all likelihood, some people would end up paying more, although hopefully for more benefits. A mandated plan might well bring in some congregations and other institutions that have been trying to do it alone, or trying to do without; and some might certainly resent it. At the same time, a good analysis of the information should identify those concerns, and “viable alternatives” might provide choices.

Regular readers will know that I believe in a government-supported program for universal access to and coverage for healthcare. That said, I don’t expect it to happen in any meaningful sense before the 2009 General Convention. (I learned all too well from the misplaced optimism of the early Clinton years.) So, this might well provide better for so many of my colleagues in ministry in the Episcopal Church while we work for a system to provide better for everybody.

One thing that did happen at our Diocesan Convention is that I was elected a Deputy to the General Convention in 2009. I’ll have chance to vote on this, and perhaps to speak to it. I can hardly wait to see what the report will say.

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