The Department of Social Services Commissioner outlined the benefits Wednesday of Gov. M. Jodi Rell’s Charter Oak health insurance plan estimated to cover 8,700 uninsured residents in the state by the end of 2009.
DSS Commissioner Michael Starkowski said by the end of December he intends to put out a request for bids on the Charter Oak plan, but after hearing more than four-hours of testimony from advocates and consumers, Senator Jonathan Harris, D-West Hartford, asked him if he would delay it’s release based on a number of concerns expressed Wednesday. But Starkowski wouldn’t budge on the release date.
Rep. Deborah Heinrich, D-Madison, said based on the benefits offered in the plan a family of four with an annual income of $63,000, which is above 300 percent of the poverty level, would be paying $15,000 to be on this plan and that’s before co-pays. She said the plan brings that family from over 300 percent of the federal poverty level down to 200 percent of the poverty level.
Starkowski tried to put her comments into perspective. “We’re talking about people who are uninsured,” he said. He said “we’re not going after people who already have health insurance,” and “we’re trying to keep the plan affordable,” with the $250 per month premium.
But like most things that are complicated “it’s the details that matter,” state’s Health Care Advocate Kevin Lembo pointed out. He said he feels like the state is trying to back into the $250 premium, instead of coming up with a sustainable plan for the uninsured. He said if the state does not price the product fairly then it’s about “giving affordable health insurance to people who can’t afford it.”
Starkowski said the only way we can make this plan work is to attract enough healthy people to balance out the risk of the chronically ill people that may find it appealing because a preexisting medical condition does not exclude you from the plan.
However, Starkowski and the three legislative committees heard just how difficult it would be for consumers with chronic illnesses to afford the plan with the high deductibles. The annual drug benefit is $2,500, for durable medical equipment it’s $2,000 and there’s no mental health parity contemplated as part of the plan.
“The Charter Oak plan will be worse for the chronically ill than nothing at all,” Jennifer Jaffe, an attorney and advocate for the chronically ill, said. “It won’t protect the chronically ill from medical debt.”
Jaffe, who has Crohn’s disease said the discounted amount she pays for her medication is $1,852 per month, which means she would be paying out-of-pocket for her medication after the first few weeks of the second month. Over the course of a year, she said her medication would cost more than $20,000.
Jaffe pointed out that, “More than half of the uninsured have at least one chronic condition.” And even preventative care such as a colonoscopy has a 20 percent co-pay, which will cost people $1,000, she said.
Lembo said it’s unlikely his son, a healthy 23-year-old, would find the plan attractive because he can do better shopping for a plan in the private insurance market.
Lembo said he’s also worried about the lack of mandates. The package he gave to the three legislative committee’s include his correspondence with the Insurance Department Commissioner Michael Sullivan who opined in a Nov. 30 letter that “the Charter Oak Health Plan is not commercial insurance subject to Department regulation; it is a social program.”
Lembo is quick to point out that many people who may want the insurance are over 300 percent of the federal poverty level and won’t have their premiums subsidized by the state.
Harris said he’s concerned about the notion that “any coverage is better than no coverage.” Starkowski said the plan is “not meant to be the end all be all for the entire population of uninsured.”
“I can appreciate that this is not a panacea here…but what are we actually trying to capture?” Harris said.