DOVER — Budget-writing lawmakers got updates on state employee health care Thursday and continued to push back against the administration’s plans to increase the amount employees pay and limit the number of choices they have for care.

Gov. Jack Markell in January recommended raising premiums by between $1.98 and $19.48 per month, as well as locking future employees into a new Health Savings Account and ending a grandfathered-in provision that lets spouses on the same plan pay $25 per month for medical care.

The changes would reduce skyrocketing costs and avoid a deficit projected to hit $383 million in five years without any changes.

However, employees and subsequently, lawmakers, have objected.

Thursday, with state budget Director Ann Visalli speaking before the Joint Finance Committee, several legislators criticized plans that would place greater limits on employees in regard to their health care.

The goal of the potential changes, Ms. Visalli stressed, is to make employees better consumers and thus save taxpayer money. By seeking more cost-effective care, state workers would have lower medical bills, in turn requiring saving state funds.

“Our state, as have many, many states, struggled with how to get employees engaged in healthier behavior,” Ms. Visalli said. “Whether healthier behavior means your eating, your obesity, your smoking, managing your chronic disease like diabetes — which we’ve heard about, which is very prevalent in our population — exercising more, managing your depression, managing stress — all of these things, there are a lot of resources available.

“We have trouble getting employees involved, including the fact that we offered a $200 incentive for employees just to put in their blood pressure, their weight, just basic things and we couldn’t — which is almost as much as some employees pay for health care in a whole year — and we just couldn’t get employees engaged. So we continue to look at creative ways to do that.”

She also said the state is considering restricting plans based on employees’ lack of attention to cost-effective care. Workers who do not complete aspects of a health management program would face higher premiums, although the proposal would have to be approved by the General Assembly.

But her comments were not well-received. Rep. Joe Miro, R-Pike Creek Valley, said the ideas pitched by officials sounded like socialism.

“This begins to touch upon forcing the individual to go to a particular place in order to receive the care, so we have to be really careful that we respect the right of the consumer,” said Rep. Miro, who noted he left his native country of Cuba to escape communism.

Ms. Visalli responded officials would not mandate workers use a particular provider but are concerned about how tax dollars are spend.

“We have an obligation to try to make sure we’re getting the best bang for the buck,” she said.

Sen. Brian Bushweller, D-Dover, took a similar stance as Rep. Miro.

“It’s easier to say, ‘Well, gee, state employees don’t pay nearly as much as somebody else,’” he said. “But at the same time, if a retired state employee has built a financial structure around a certain level of income and a certain cost for their health insurance, I think it’s very unfair to just sort of come in in one fell swoop and say, ‘Look, we got a problem here and we have to jack up your rates.’”

Committee Chairman Sen. Harris McDowell, D-Wilmington, said the state is “sitting on the threshold of a very large change” and urged lawmakers to be cautious.

Rep. Melanie George Smith, D-Bear, suggested legislators wait before approving higher premiums and instead focus on lowering costs through incentivizing healthy behavior and low-cost care.

Sen. McDowell, who has stated on multiple occasions he believes providers are charging greatly marked-up prices, speculated that the state could work with insurance companies to get advice on prices and find better deals.

With JFC reluctant to pass greater costs on to state workers, no changes will be made yet. For now, state officials will attempt to promote more efficient care and avoid having to make the changes recommended by the governor.