Posted: Monday, 30 June 2008 5:08PM
New CT Health Plan Accepting Applications
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ROCKY HILL, Conn (AP) -- Mariana Luari would like to provide her 12 employees at the Town Line Diner with health insurance, but she and her husband can't afford it.
``When they get sick, I'm worried,'' she said. ``Most of my employees just go into Stop and Shop and take over-the-counter medication. It takes them forever to get healthy.''
That's why Luari was beaming on Monday when Gov. M. Jodi Rell chose her diner to announce that the state is accepting applications for the new Charter Oak Health Plan _ a basic health insurance policy being offered to uninsured adults.
``It's a big day for us,'' Luari said. In 2006, neighboring Massachusetts passed legislation creating near universal health care coverage for residents. The program requires adults to purchase health insurance or else face financial penalties. It offers government subsidies to help people cover the cost.
Connecticut decided not to make its initiative, aimed at helping the estimated 5 to 6 percent of state residents without coverage, mandatory.
The state sought bids from private insurance companies willing to provide a basic benefits package, ranging from primary care office visits to maternity care, for a low premium. Depending on a person's income, premiums can range from $75 to $259 a month. The state is subsidizing premiums for lower income participants.
Enrollees with pre-existing medical conditions will also be covered.
``There is no other plan like this, by the way, in the United States,'' Rell said. ``We are leading the way.''
Ken Thorpe of Atlanta's Emory University, a health policy researcher, said Vermont and Maine have both come up with affordable insurance plans similar to the Charter Oak Health Plan that include subsidies for low income enrollees.
``It's a good middle ground'' Thorpe said of the concept, adding how many states would be hard-pressed to cover the cost of a true universal health care system. In 2007, a proposal before the Connecticut General Assembly creating such a system was estimated to cost in excess of $17 billion.
But Thorpe said states like Connecticut, Vermont and Maine have to make sure that people with chronic conditions, such as diabetes and pulmonary disease, aren't discouraged from seeking ongoing medical maintenance because of high deductibles.
``For those individuals, the challenge is, you want to make sure they get the primary health care, they take their meds and so on,'' he said.
Under Charter Oak, there are $25 copays for primary care office visits and $35 copays for visits with specialists. Preventive care visits are covered 100 percent, while deductibles for inpatient hospital treatment, outpatient surgical and inpatient rehabilitation and skilled nursing range from $150 to $900 for an individual.
Department of Public Health Commissioner Michael Starkowski predicts 15,000 to 17,000 people will sign up for Charter Oak in the first year. Those numbers are expected to grow. Enrollees can expect to begin getting coverage as early as Aug. 1.
In order to be eligible, enrollees must be uninsured for at least six months. But Rell said there are some exceptions under the plans' rules.
Concerns were raised by state lawmakers last session that Charter Oak did not provide enough coverage for pharmacy and other benefits. But attempts to pass legislation mandating expanded coverage failed.
Some lawmakers, mostly Democrats, have said the state should still pursue a more universal health care system despite the Charter Oak plan.
Andrea Bryant, a 57-year-old waitress from Manchester, said she's happy to sign up for a basic health plan. She has been without coverage since her husband died two years ago. She couldn't afford to pay the $700 monthly premium and had to drop the policy.
Since then, Bryant has gone into debt after paying for medical expenses out-of-pocket. She has problems with one of her knees, and said it's ``very, very scary'' not to have any coverage.
``This is such a good day for me,'' said Bryant, after filling out one of the first applications for Charter Oak. |
Copyright MMVIII The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.
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