NC health plan proposal penalizes smoking

"I do not feel like we are throwing premiums on the back of members," said board member Bill Medlin. "We have choices."

The smoking surcharge brings the question full circle in state government. While under Democratic control, the legislature approved changes to the State Health Plan that penalized smokers with less-generous coverage starting in July 2010 and would have applied to very obese people starting July 2011.

But the Republican-led General Assembly repealed those programs after state workers found the rules too intrusive.

The General Assembly shifted State Health Plan governance to State Treasurer Janet Cowell's office in the 2011 legislation that also helped close an estimated $515 million shortfall for the plan through mid-2013. The plan had faced repeated shortfalls since the early 2000s that required higher premiums and narrowed benefits.

Lawmakers don't make choices on insurance plans but will still have influence because the proposal requires lawmakers to provide extra cash to help cover claims. Monday's plan would need $181 million from the state's coffers over two years, including $45 million in the 2012-13 fiscal year.

The current State Health Plan coverage charges state employees no premium for a less generous plan and $22.76 per month for a more generous plan. The monthly premium for state workers and their families combined is $543.54 per month for the less generous plan and $666.18 per month for the more generous plan.