Charter Oak Plan Coverage Under Fire

HARTFORD (AP) — Some advocates for the uninsured say Governor M. Jodi Rell’s proposed Charter Oak health care plan won’t provide enough coverage for certain people, especially those with chronic diseases such as HIV/AIDS and diabetes.

They claim the plan’s limits on drug benefits and medical equipment are too low and the insurance co-payments are too high.

“Someone with HIV/AIDS could reach the medication cap in a month or two at most,” said Shawn Lang, director of public policy with the Connecticut AIDS Resource Coalition. “And the 20 percent copays for lab tests commonly needed by people with HIV/AIDS can mean hundreds of dollars.”

But state officials say Gov Rell’s initiative is not supposed to be the Rolls Royce of insurance coverage, but rather a way to target the four or five percent of Connecticut residents who are uninsured and do not qualify for other programs.

“Rather than being kind of the super-costly universal health care approach, this is a targeted program that goes directly to people who currently do not have coverage,” Rell spokesman Chris Cooper said.

Mr Cooper said hundreds have called Gov Rell’s office, asking when Charter Oak will be up and running.

Several legislative committees held an informational meeting on the plan Wednesday. Lawmakers already have approved some funding to advertise Charter Oak. Ultimately, the insurance companies will offer the plan, not the state.

Under the plan, uninsured adults would pay about $250 a month for coverage. Lower income enrollees would be able to apply for premium assistance from the state and possibly be eligible to pay only $75 a month.

The state hopes Charter Oak will begin taking enrollees on July 1, 2008.

Patient advocates criticized the prescription drug benefit under Charter Oak, saying it would be limited to $2,500 a year and $1,000 a year for medical equipment. They are also worried that several mandates for insurance coverage, such as minimum hospital stays for childbirth, won’t apply to Charter Oak.

“It makes much more sense to keep people healthy by providing adequate insurance benefits,” said Don Zettervall, director of the Diabetes Center of Old Saybrook.

The prospectus sent to insurance companies interested in providing services under the state-sponsored plan did not include a figure for prescription drugs, but called for a $2,000 benefit for medical equipment.

David Dearborn, a spokesman for the Department of Social Services, said DSS is still seeking input from various groups about Charter Oak and there may be a range of benefits and costs enrollees can choose from.

“We’re not quite sure what that will entail yet,” he said. “Insurers may be able to provide higher benefits at different costs.”

Charter Oak is expected to cover about 32,000 uninsured individuals. These could range from newly minted college graduates to older people not yet eligible for Medicare.

Mr Dearborn said the program was not designed to be a universal health insurance type of program, something some legislative Democrats prefer.

“It was proposed as a practical, affordable way to connect uninsured adults with health coverage — affordable for the adults and affordable for the taxpayers,” Mr Dearborn said. “If we look to fund the Rolls Royce at the outset, it could collapse under its own weight before it gets started and that is the balance we’re trying to strike here.”