Christine Stuart photo

Democrats and Republican Gov. M. Jodi Rell took each other to the proverbial mat again Tuesday as they argued over Rell’s Charter Oak Health Plan approved last year by the legislature.

This year, Democrats have proposed legislation to increase the benefits and delay implementation of the plan, which has been offered as an affordable $250 per month health insurance plan for uninsured adults.

Democrats say they’re just trying to make the plan better, but Rell contends they’re trying to derail it.

Department of Social Services Commissioner Michael Starkowski spent most of Tuesday morning defending Rell’s plan at a public hearing where he heard many of the same concerns from legislators that he heard before the plan went out to bid this January. Click here to read more about what happened in January.

Rell said at an afternoon press conference that HB 5617 could “derail this plan altogether and we don’t want that to happen.” She said everywhere she goes she gets asked, mostly by waitresses, hair dressers, and at least one clerk in a bookstore, about when the plan will be available.

Starkowski said his agency listened carefully to health care advocates who have warned that the plan doesn’t offer enough. For example, the pharmacy benefits were increased from $2,500 a year to $7,500 a year and the deductibles have been lowered from $1,000 to a low of $100 based on income.

“This is a workable, affordable plan,” Rell said.

Starkowski said HB 5617 removes all the flexibility in the plan. It removes the proposed caps on pharmacy benefits and durable medical equipment, which would benefit those with chronic illnesses.

Jennifer Jaffe, who not only advocates for the chronically ill but also suffers from a chronic illness herself, has said the increase in drug benefits means the $1,800 she spends every month on discounted drugs would last her maybe four or five months. The rest of the year she would be paying out-of-pocket for her medicine, which would cost her $12,600 to $14,400 per year.

Jaffe, an attorney, has 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” she said.

At the public hearing Tuesday, State Healthcare Advocate Kevin Lembo said, “The state should not be in the business of marketing and setting the precedent for the proliferation of limited benefit plans as a part of the solution to the problems of uninsurance. What will remain are a significant number of people who are underinsured.”

And what happens if the insurers’ bids for the Charter Oak Health Plan are higher than the proposed $250 per month premium?

Starkowski said the state has asked potential bidders to adjust the benefit levels in the plan if they don’t think they can meet the $250 per month premium within the proposal. This means there’s no guarantee the benefit levels in the RFP would remain once the insurers began offering the plan. Advocates say HB 5617 attempts to increase—and at the very least, mandate—the benefit levels outlined in the original bid.

Meanwhile, the price tag for the plan continues to go up. Last year its estimated cost was $11 million, but since then Rell has asked the legislature to approve an additional $6 million to pay for what she expects to be an increase in enrollment.

Starkowski said estimated enrollment in the first year has gone from 8,700 to more than 10,000. The plan will be offered for the first time this July, if the proposed legislation is not passed.