Is there a Health Care Backlash Brewing?

PROVIDENCE, R.I. — Waiting in line at the pharmacy to pick up prescriptions, Lawrence Cafero Jr. can't help but feel a bit guilty.

Cafero is a state representative in Connecticut and taxpayers subsidize his generous health insurance plan, which requires only a $10 copay for any brand-name prescription drug.

"I'm standing behind either an elderly person or a working-family person and they're taking out wads, like dropping 20, 40, 60 bucks. And I've got $10 — $5 for a generic," said Cafero, R-Norwalk. "I'm embarrassed."

Pressure is mounting in states hit worst by the recession to take back some of lawmakers' generous health benefits that are funded by taxpayers.

A review by The Associated Press showed lawmakers in 12 states get health insurance for free, while those in 28 states share the costs with taxpayers, often getting a better deal than private sector workers.

In California, where finances are so bad the state has issued IOUs, the citizen commission that sets benefits for elective officials voted in June to reduce funds for lawmaker health insurance. The change takes effect in December.

"There are employees on furlough and people being laid off," commission member Ruth Lopez Novodor said. "It just didn't seem right to keep the compensation at the same levels."

In Michigan, supporters are renewing efforts to end lucrative retiree health benefits for lawmakers or at least force lawmakers to work longer before they qualify for them. Similar proposals failed in 2007.

"What's good for us should be good for them," said Ray Holman, a child abuse investigator for the Michigan Department of Human Services, who has seen his health insurance costs rise steadily. He will lose six days of pay this year as state leaders try to close a deficit.

"When you see the lawmakers who have the generous benefits and appear to be working part-time, it's just not good leadership," Holman said.

Meanwhile, many Rhode Island lawmakers accustomed to free health insurance at taxpayer expense have bowed to public pressure and started voluntarily contributing toward its cost.

Last year Rhode Island cut state-funded health care for immigrant children and 1,000 adults, forced the poor to take cheaper generic drugs and raised health insurance costs for state workers.

Yet Sen. Charles Levesque, D-Portsmouth, believes his free health care reasonable considering lawmakers make $14,018 in salary. Although they meet only about six months a year, Levesque, an attorney, considers his elected post a full-time job.

"I am the senator from Portsmouth when I walk out in my bathrobe to get my newspaper in the morning, when I go to the local pharmacy to buy whatever prescription medication I need to keep me going," he said.

Federal lawmakers, who are debating an overhaul to the nation's health care system, also get subsidized insurance. Members of Congress are covered by the federal employees health plan and get VIP medical access at Walter Reed Army Medical Center in Washington and the National Naval Medical Center in Bethesda, Md. For about $500 a year, federal lawmakers can also have unlimited visits with a physician assigned to the Capitol for routine care.

At Tuesday's town hall meeting in New Hampshire, President Barack Obama was asked why he hadn't talked more about the differences between the benefits offered to federal lawmakers and the system for everyone else. Obama responded that his proposal would give the public options similar to those given to federal employees.

Some state lawmakers also receive generous benefits:

_ Michigan lawmakers get retiree health care after six years of service and can tap into their benefits at age 55. That perk is the envy of workers in a state with 15.2 percent unemployment rate.

_ Members of the Massachusetts Legislature pay about $200 to $230 per month for family health coverage, about 18 percent less than what the average U.S. consumer pays, according to a national survey by the Kaiser Family Foundation and the Health Research and Educational Trust.

_ Connecticut lawmakers get retiree health insurance after working a decade for the state. Some lawmakers get retiree health care for free, while others pay 3 percent of their salaries. Brand-name drugs require a $10 co-payment.

In comparison, about 63 percent of employers offered health coverage last year, according to Kaiser's annual survey of roughly 1,900 firms. Health insurance for the average single employee ran around $4,700 annually, and workers paid 16 percent of the tab. Premiums for family plans averaged around $12,680, and workers were responsible for 27 percent of the cost.

The disparities could influence how lawmakers think, said Peter Sepp, a vice president for policy and communications at the National Taxpayers Union.

"It can skew their perspective on how much it might cost a family or small business to provide such insurance," he said. "It can also in some instances lead them to believe that the affordability of their coverage is something that the entire nation can be made to afford."

Not all lawmakers have it so easy. Legislators in New Mexico, South Dakota and Wyoming cannot get state health insurance, while their counterparts in Nebraska, Nevada, New Hampshire, West Virginia, Alabama and Vermont must pay the full price themselves if they want state coverage.

Vermont Rep. Carolyn Partridge, D-Windham, went without health insurance after being elected to office. As a farmer, she cannot afford to pay for the state health plan. Partridge and her husband now qualify for Medicaid.

They paid out-of-pocket for an annual physical and have avoided treatment for anything except emergencies. Partridge said hospitals are willing to work out payment plans for the uninsured.

"The bottom line is, you get taken care of," she said. "The worst bottom line is they take your house, if you own one."

In Rhode Island, House lawmakers passed a bill last year requiring lawmakers to pay 10 percent of their premiums, but it died in the Senate. A similar bill sponsored by Rep. Amy Rice, D-Portsmouth, never made it to the floor this year.