Managed Healthcare Executive - November 2008 - (Page 13)

Aﬀordable access As a government-subsidized, public-private plan, Charter Oak Health Plan bridges the gap for the uninsured in Connecticut story | Tracey Walker photography | Jay Misencik J ohn (not his real name), 47, a parttime manufacturing worker from Torrington, Conn., with no employer insurance and numerous medical bills, couldn’t a ord commercial insurance. He had no medical conditions that would qualify him for a state high-risk program and was not eligible for Medicaid. He embodied the reality of the working uninsured, which accounts for some 38 million of the 47 million uninsured in the United States. In June, the State of Connecticut launched the Charter Oak Health Plan— the rst government-subsidized, public-private health plan in the country that does not place mandates on individuals or employers, does not require income limits, does not exclude pre-existing conditions and o ers guaranteed issue. John was one of the rst citizens in Connecticut to enroll in Charter Oak. With sliding-scale premiums ranging from $75 to $259 and annual deductibles ranging from $150 to $900, Charter Oak was perfect for him. “He pays $75 a month for coverage—affordable for him—and a small copay for prescriptions,” his sister says. Gov. M. Jodi Rell proposed the $11million state-subsidized Charter Oak plan for uninsured adults, like John, ages 19 to 64, who don’t qualify for other programs. “When Governor Rell discussed her vision for addressing the ranks of the uninsured in this state, there was no question that I was energized to help develop the details,” says Department of Social Services (DSS) Commissioner Michael Starkowski. “There hadn’t been a lot happening on the national scene in terms of addressing the uninsured.” Charter Oak bene ts are delivered by a commercial health insurance model, with deductibles, copayments and coinsurance. Plan participants are enrolled in Aetna Better Health, AmeriChoice by UnitedHealthcare or Community Health Network of Connecticut. “CMS has actually hardened its stance on some of the creative plans that are being proposed by states that look for federal nancial assistance to address the uninsured,” Starkowski continues. “Governor Rell decided that Connecticut would take the initiative to do something positive, on our own if necessary. As the administration changes, we’ll continue to work with CMS and see if they will help us address the problem in terms of nancial participation—as is the case in Medicaid and SCHIP.” A perfect t Charter Oak complements the DSS’s two HUSKY (Healthcare for UninSured Kids and Youth) programs, which provide healthcare to children, regardless of family income. HUSKY A covers children up to age 19 and eligible parents/relative caregivers as well as pregnant women up to 185% of the federal poverty level (FPL). HUSKY B covers only children up to age 19 in households earning more than 185% of FPL. Children in households earning 300% of FPL or more can be covered at the full state-negotiated grouprate premium. Transitional Medicaid is o ered for one year to parents/relative NOVEMBER 2008 13

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Managed Healthcare Executive - November 2008 For Your Benefit Editorial Advisors Contents News Analysis State Report Politics &�Policy Letter of the Law Affordable Access Economic Ripple Effect Hospitals &�Providers Technology Managed Care Outlook Desktop Resource Ad/Edit Index

Managed Healthcare Executive - November 2008

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