Office workers are paying higher health-insurance premiums. So are farmers, store clerks and factory employees.

But while health care costs skyrocket for most Americans, one group still gets its coverage for free:

Members of the state House of Representatives.

Pennsylvania taxpayers pick up the entire tab for all 203 representatives' health premiums, valued annually at around $15,000 each.

Pennsylvanians also pay the full premiums for 1,769 House staffers enrolled in the health plans.

House members' health plans come with no in-network deductibles and low co-pays. The plans offer brand-name prescription drugs for $6 and doctor's office visits for $10.

And lawmakers' coverage doesn't necessarily end with their terms. After 10 years of service, House members and their spouses qualify for lifetime health benefits. Those, too, come at taxpayer expense.

In the other branch of the state Legislature, senators and their staffers contribute 1 percent of their salaries toward all benefits. For senators, that translates to around $783, well below the average Pennsylvanian's annual $2,971 contribution just for family health coverage.

The bottom line: Taxpayers' annual bill for House health premiums totals $20.7 million for members and their staffs, but not retirees. Health benefits for state senators and their staff members and retirees cost Pennsylvanians another $19 million.

Health care at low or no cost to workers is increasingly rare, as employers struggle to remain profitable in a difficult economy.

Workers who in the past paid little or nothing for health insurance — including public-safety personnel and teachers — now cover a growing share of their premiums, deductibles and other costs.

Tim Potts, co-founder of Democracy Rising PA, a nonpartisan government watchdog group, says legislators and their staffs should pay what the average worker does for health care.

"So many people don't have health insurance at all," Potts says. "For legislators to be totally dependent on taxpayers for this benefit is simply out of line with what constituents have to live with."

State employee benefits
In other states and at other levels of government, it's uncommon for elected officials to have better health benefits and lower costs than their co-workers or employees.

Members of Congress, for instance, have the same choices, coverage and costs as all federal workers. The Lancaster County commissioners' benefits are no different than those of other county employees.

But Pennsylvania legislators have additional health-plan options that other state employees do not. And House members pay less for coverage.

Most state employees in Pennsylvania choose from four to six health plans, including PPO, HMO and high-deductible options. The state's Web site highlights generous benefits as a recruiting tool.

Before Gov. Ed Rendell's tenure, state employees did not contribute toward health-insurance premiums, spokeswoman Mia DeVane says.

But due to rising costs, employees under the governor's jurisdiction — the majority — now contribute 2 percent of their base salary toward health insurance, DeVane says. State employees who sign up for a wellness program can halve their contribution.

State employees pay an average of $660 annually for health benefits. (This figure is an average of both single and family premiums.)

The average Pennsylvanian pays $852 for single coverage and $2,971 for a family policy, according to a 2009 Kaiser Family Foundation/Health Research & Educational Trust survey.

The governor has the same plan choices, coverage and costs as other state workers, DeVane says. "He's treated just like a state employee when it comes to his health plan."

The House and Senate, however, independently determine their members' health benefits.

Richard Cauchi, the National Conference of State Legislatures' program director for health, says he's aware of only one other state — Florida — in which lawmakers pay lower health-insurance premiums than other state employees.

What legislators get

House
The chief clerks of the state House and Senate would not answer questions directly about legislators' health benefits.

The newspaper ultimately obtained the information by filing Right to Know requests.

All 203 House members are currently enrolled in a state health plan, according to the chief clerk's written response.

Representatives and their staffs can choose from four free plans: a traditional plan, a PPO or one of two HMO plans.

Lancaster County Reps. John C. Bear, Scott Boyd, Tom Creighton, Bryan Cutler, Gordon Denlinger, Dave Hickernell and Katie True are enrolled in the PPO plan with family coverage. Rep. Mike Sturla has the traditional plan with family coverage.

None of the four House plans has an in-network deductible. Office-visit co-pays of $5 to $15 are well below the average worker's costs of $20 to $28, according to the Kaiser survey.

House members and their staffs pay $1 to $6 for prescription drugs, including brand names.

This coverage differs significantly from what is offered to state employees who live in Lancaster County. According to a state employee benefits Web site, those workers pay $10 to $36 for prescriptions, plus any cost difference between a brand-name and generic drug.

The House dental plan covers 100 percent of preventive care and fillings, as well as endodontics (root canals), prosthetics (dentures, bridges) and complex oral surgery. There is a $3,000 allowance for braces.

All four House plans have an unlimited lifetime maximum, which means there is no cap on what the insurer will pay. This practice is steadily declining elsewhere. According to the Kaiser survey, 41 percent of U.S. plans had no lifetime limits in 2009, down from 49 percent in 2004.

House members also pay nothing toward long-term care, long-term disability and life-insurance premiums.

The average cost to taxpayers varies, depending on the health plan selected and whether it covers a spouse and/or dependents. Published reports put the average annual cost at around $15,000 per legislator.

After 10 years in the House, representatives and their spouses are eligible for free lifetime health care.

U.S. Rep. Joe Pitts, who served in the state House for 24 years, is not enrolled in a federal health plan, which requires members to contribute toward premiums, his office says. Pitts has retained his free state coverage.

Senate
In 2006, soon after public furor erupted over the midnight pay raise, state senators agreed to contribute 1 percent of their salary toward benefits.

For a senator making the average base salary of $78,314.66, 1 percent is about $783. That contribution goes toward all benefits, including health insurance.

Currently 818 senators and employees, along with 499 retirees, are enrolled in a state health plan, according to a written response from the chief clerk's office.

Senators, staff members and retirees choose between a PPO or traditional plan. Both have no in-network deductible or lifetime maximum.

In the PPO plan, senators pay $5 to see a primary-care physician or specialist. Members of both plans pay $6 to $26 for prescription drugs.

Senators qualify for lifetime coverage after eight years of service. Retirees contribute the equivalent of 1 percent of their final legislative salary toward benefits.

Sens. Mike Brubaker and Lloyd Smucker are enrolled in the PPO plan with family coverage.

Sen. Mike Folmer, a Republican whose 48th District includes parts of Lancaster County, is the lone local legislator to turn down the General Assembly's benefits program.

Folmer's wife is a state employee. He is enrolled in her health plan, which he describes as far less generous than the options offered to senators.

The state constitution forbids compensation for lawmakers, beyond salary and mileage reimbursements, Folmer says. At the very least, he says, all state legislators should pay what average workers do for health care.

"People in the private sector pay for their insurance," he says. "We're no better."

Joe D. Sterns, communications director for the nonprofit Commonwealth Foundation, a public-policy group that favors limited government, agrees that a 1 percent contribution doesn't go far enough.

According to 2008 data from the U.S. Bureau of Labor Statistics, Pennsylvanians make an average annual salary of $40,630 — roughly half of lawmakers' base earnings.

The statewide average worker contribution for a single health-insurance premium ($852) equals 2 percent of that average salary. The average contribution for a family policy ($2,971) would be 7 percent.

"There's a huge gulf between the world outside Harrisburg and what the politicians enjoy for their health care," says Sterns, a former House and Senate staffer. "The health care benefits enjoyed by state legislators ... are those that taxpayers could only dream of."

Time for change?
Good, low-cost benefits traditionally have balanced out government workers' relatively low salaries, says Bear, a Republican who represents the 97th District.

But he expects House members will soon pay for health coverage.

"It's got to change," Bear says. "I don't think taxpayers can afford it."

On Wednesday, state Attorney General Tom Corbett, a Republican candidate for governor, unveiled a reform proposal that includes House member contributions toward health insurance. On his Web site, Democratic candidate Dan Onorato says legislators should pay a "reasonable share" of health-benefit costs.

Other gubernatorial candidates do not directly address the issue on their Web sites.

Rep. Steven Santarsiero, a Bucks County Democrat, recently introduced a bill that would require future members to contribute 1 percent of their salaries toward health insurance. The bill was referred to the state government committee in December.

All local representatives say they support member contributions.

"Plenty of us in the House are trying to change the system," says Cutler, a Republican who represents the 100th District and is a co-sponsor of the bill, along with Boyd.

House members have discussed the idea of contributing to their benefit costs for several years, says Boyd, a Republican who represents the 43rd District. Requiring members to contribute — like private-sector workers already do — is a matter of equity, he says.

"We're a reflection of the people," Boyd says. "I think we should, in that sense, lead by example, not be the last to get on board, so to speak."

Creighton, a Republican who represents the 37th District, says that in addition to member contributions, he supports investigating the merits of alternatives, such as high-deductible plans or reducing current coverage.

"It's more than I need," Creighton says of his current health plan.

Denlinger, a Republican who represents the 99th District, says members are actively looking at ways to control costs and ease financial burdens on taxpayers.

Denlinger says he believes there is broad support for a member contribution. But, he says, members also must consider how such a change would impact retirees and legislative staffers, who make fairly modest salaries.

"If we're paying low market rates for [staff] salary, is adding an extra charge for health benefits really the right thing to do?" Denlinger says.

Of course, he adds, legislation isn't the only route for requiring representatives to contribute toward health care costs.

House leaders could simply decide to change the policy.

Sturla, a Democrat who represents the 96th District, says that while a member contribution might be a good gesture, it wouldn't significantly curb costs.

"It's not like if I just paid 1 percent of my health care costs, we wouldn't have a deficit," he says.

mschweigert@lnpnews.com