PHILADELPHIA–This day-long discussion of health care coverage was packed with both statistics and emotion – a reflection of how much was at stake for both Presbyterian pastors and their congregations.
Here’s some of what members of the Board of Pensions health care committee had to say March 8 as they sifted through alternatives for changing the dues structure of the medical plan of the Presbyterian Church (U.S.A.)
Stressful. John Hamm, the committee chairman, said he found it difficult to “sit on my hands” and not respond as critical letters, e-mails, blog posts and phone calls poured in responding to a proposal the board presented at its meeting in October. So Hamm claimed an hour at this meeting to speak his mind, and to work his way point-by-point through much he had longed to say in the past four months.
“It has been an incredibly stressful period,” Hamm said – adding “we realized there would be a great deal of pain” and “there will be blood” if health coverage costs increase for plan members to provide coverage for their families.
“We had no idea it would be our blood,” he said.
Intentions. Hamm said the board’s efforts over the past 18 months to propose workable changes had two aims. The first was to maintain the long-term viability of the board’s health care coverage. The second was to provide churches with some flexibility in paying medical dues.
Currently, congregations or employers pay the entire cost of medical coverage for a member and that person’s family. The Board of Pensions set up that system in the 1980s, to offset the low salaries of many pastors and church workers.
Back then, those dues amounted to just 8 percent of effective salary; now they come to 21 percent, and that’s still not enough to cover expenses, particularly with a 400 percent increase in health care costs and a 20 percent decrease in the number of members.
Sharing. Hamm stood for emphasis – using his height to press his point. In the proposal presented in October, the board did not mandate that plan members with dependents would have to pay all the additional costs – the 35 percent of costs for providing medical coverage for partners and children that the dues would no longer cover. Instead, Hamm said, the board proposed to leave it up to the church or other employer to determine whether to pay the full cost or pass some or all of it on to the plan member.
“We did not push that. We did not say you must allocate” the cost to the member, Hamm said. “We said you may allocate. And what better place to make that decision than the church itself?”
The matzo ball. In January, “this incredibly large matzo ball fell right into our health care soup,” Hamm said. In that month, a $5,700 price tag was put on the cost for dependent coverage – a price of about $475 per month for both a partner and children, or $5,700 a year.
Hamm said he was aware the cost would be in the $5,000 to $6,000 range, but “I am wearing secular glasses. I have been covered by a health care plan for 43 years,” and he pays more than twice that for his family’s coverage. “If you look at the secular world, that’s (the $5,700 cost) a bargain,” he said.
What Hamm did not figure in was the impact of a family potentially absorbing that cost all at once. His rates go up every year – sometimes more than $1,000 a year, but never $5,700 a year, a jump that one writer described as “unconscionable.”
Hamm said he agrees with that assessment. “If it happened to me, I would have written a letter. I would have said it’s terrible.”
He said he was particularly affected by heart-wrenching comments written by young pastors saying they deeply wanted to serve in ministry and need medical coverage for their partners and children – but do not have an extra $5,700 to give.
Peacemaker. Hamm said he was troubled by criticism of the proposal that pitted Presbyterians against one another – big churches against small ones; wealthier pastors against those barely making it; big families against single people; older ministers against younger ones. He said he wants to be a peacemaker by presenting options that give churches some discretion and flexibility but are not perceived as divisive.
Principles. Hamm said the board’s plan is built on three principles: community; neutrality of call (so congregations can call any pastor without worrying about how that person’s family configuration will affect their health care costs); and the requirement that the church or employer pay the entire cost of health coverage for plan members and their families.
Any impact on the first two principles – and Hamm acknowledged there had been some – was unintentional, he said. The board did, however, intend to engage the question of whether plan members should shoulder some of the cost of medical coverage for their partners and dependents, although they held fast to the concept that the member’s medical coverage should be paid in full by the church.
When Hamm had finished, other committee members spoke too. “It’s hard not to take things personally,” said Stephen Proctor. The PC(USA) has so many small churches, “and they’re increasingly at risk. The likelihood that many of them are seeing their last called-and-installed pastor is incredibly painful.”
Committee member Robert Gorksy said he was troubled by misinterpretations in some of the criticism. Gorsky said the October recommendation “makes a lot of sense and provides flexibility for congregations,” and added, “I just don’t think we should cave in to the whiners.”
Committee member Brian Ellison disagreed with that characterization. He said the October plan’s critics are, “at the end of the day, the plan members for whom we are the fiduciaries.” If the board takes the criticism personally, “we may well do the wrong thing,” he said.
Hamm admitted he has taken some of the criticism personally. “It’s my nature to lash out,” he said. “Perhaps that’s the value of having to sit on my hands” and listen.