One day after Gov. M. Jodi Rell unveiled her request for proposal to cover more than 30,000 of the 400,000 uninsured adults in the state by 2011, advocates are lining up to criticize it.
“We are pleased that the Governor recognizes the severe plight of the uninsured in this state. However, advocates are very concerned that this proposal has been developed by DSS [Department of Social Services] completely in secret, with no opportunity for input from consumers, providers or advocates,” Sheldon Toubman from New Haven Legal Assistance Association said. He said the details given in Rell’s press release and the prospectus are sketchy.
Ellen Andrews from the Connecticut Health Policy Project said, “We are concerned that the proposal does not include initiatives adopted by other states in their health care reforms, like disease management and chronic care coordination that could reduce health care costs for everyone in Connecticut. We are also concerned, based on the experience of other states, that the actual costs of premiums may be significantly higher than the $250/month projected.”
Toubman said at the moment it’s unclear “if any of the commercial HMO consumer protections hard-won by advocates over many years, like the right to appeal HMO denials to an independent review, are even included.”
In addition Toubman said he is concerned because the plan lumps both Rell’s Charter Oak Plan with HUSKY, the state insurance program for low-income families that is administered by four private HMOs. He said there needs to be more transparency, “given the extensive contracting problems and lack of accountability we have seen under the HUSKY program.” He said the contracts with HUSKY HMOs are being renewed on a month-to-month basis, “in part because of ongoing disputes about accountability to the taxpayers.”
Senate President Donald Williams of Brooklyn said Wednesday that he was unaware of plans to lump to the two health care plans together and believes it should be evaluated further since research shows “it costs more when services are privatized.”
In order to address the uninsured and underinsured population in the state the legislature passed legislation this year to create two committees to study the access issues and develop a universal system for the state before reporting back to the legislature in December 2008.
In a press release Tuesday, Rell said her plan would include a full prescription drug package with co-pays as low as $10, it would not exclude people with pre-existing conditions, it would have no maximum annual benefits, and it would have co-pays for prenatal, postnatal, and preventative care that would be lower than regular office visits.
“We are looking to attract as many insurers as possible to bid on our exciting new program for adults. When the full RFP is issued next month, insurers will have the opportunity to join the competitive procurement process for adult coverage, as well as children’s coverage,” Rell said in the press release.
The full RFP will be issued next month. For a copy of the prospectus that has advocates up in arms click here.