CTNJ file photo

Legislators and health care advocates were disappointed Thursday in Gov. M. Jodi Rell and Department of Social Services Commissioner Michael Starkowski, who decided to put the Charter Oak and HUSKY insurance plans out to bid before answering questions posed during a public hearing in early December.

In a phone call Thursday, Sen. Jonathan Harris (pictured), who co-chairs the Human Services Committee, said he was “very disappointed” in the duo who seemed to ignore the concerns of legislators and the public prior to the release of the RFP.

Will behavioral health therapy, state insurance mandates, and increases in drug benefits be included in the governor’s plan to cover uninsured adults in the state?

More importantly, “Is this an actuarily sound, sustainable, and financially viable program?,” Harris asked. If it’s not then why are going to waste taxpayers money implementing it, he wondered. As harsh as that may sound, Harris said all the legislature wants to do is collaborate with the governor and DSS to help develop an affordable plan that covers the “uninsured in a meaningful way.”

DSS spokesman David Dearborn said Mr. Starkowski heard and received the legislator’s concerns, but did not respond to the Dec. 20 letter, which summarized the questions asked during the Dec. 5 public hearing. Instead Starkowski pressed for time opted to address some of the senator’s concerns through the RFP and did have a conversation with him Thursday, Dearborn said.

Some of the changes to the revised plan include increases in drug benefits, one of the suggestions made Dec. 5 during the public hearing. The RFP increases the drug benefit from the proposed $2,500 per year to $7,500 per year and the durable medical equipment benefit increases from $2,000 per year to $4,000 per year.

Attorney Jennifer Jaff, who not only advocates for the chronically ill, but suffers from a chronic illness herself said the increase in drug benefits means the $1,800 a month she spends on discounted drugs would last her until April or May, instead of February.

She said the reason they have limits on benefits is to eliminate the chronically ill. “It’s clear that they are trying to create a product attractive to young healthy people with the least incentive to sign up for it,” Jaffe said.

She said anyone with a chronic medical condition would actually be worse off on this plan than they would be with no insurance. With no insurance people may be able to get their drugs for free directly from the company, but once they sign up for health insurance that benefit disappears, she said.

New Haven Attorney Sheldon Toubman, said, “The increases, while steps in the right direction, are wholly inadequate. Annual drug costs for people with psychiatric conditions, arthritis, MS and AIDS commonly exceed $20,000 to $24,000/year and much of electronic medical equipment is well over $4,000.”

Every press release on the Charter Oak Plan emphasizes the fact that it does not exclude anyone with a pre-existing medical condition from enrolling. In order to exclude those with pre-existing medical conditions, they put limits on the services, Toubman said.

“Point to having limits on those kinds of services is to avoid selection issues associated with the chronic users of those services…This is viewed as a disincentive approach or negative plan design to avoid bad risk,” Steven Schramm, the consultant hired by DSS to design the Charter Oak plan writes in an Oct. 1, 2007
email to DSS personnel.

So while it would seem to be a plan that welcomes the chronically ill, it still considers them a “bad risk” and tries to discourage them signing up, Toubman explained.

Dearborn said the plan seeks to strike a balance. He said it needs to be attractive enough to get younger healthier people to join, so it can balance out the risk of the older population.

In the past Dearborn has said, the plan was “not proposed as the Rolls Royce of programs,” and it was by no means meant to be “universal.” However, Toubman contends that Rell’s press releases often make it sound like this is a universal health care proposal.

Rell’s press release Thursday states: “The Governor’s plan addresses what many experts have called the toughest challenge in health care nationally – bringing health care coverage to uninsured adults of all incomes.”

Meanwhile, Harris said he understands it’s not supposed to be a universal health care proposal, but sticking with the car metaphor used by Dearborn, he said, “We expect a Ford that’s going to work and not waste everybody’s money.”