Managed Healthcare Executive - November 2008 - (Page 14)

{EX EC U T I V E PROFIL E} caregivers in HUSKY A who lose income eligibility. “We wanted to ll that gap for the uninsured in Connecticut—those adults who lose HUSKY coverage or who aren’t eligible in the rst place,” Starkowski says. “Many workers don’t have access to employer-sponsored insurance. There are also situations where the full-time worker has been given access to insurance by the employer, but the coverage is still unaffordable.” Nationwide, the working uninsured fall into a gap that is seldom addressed. Starkowski witnessed the gap rsthand at a local diner while Charter Oak was on the drawing board. “I talked to individuals in the service industry, like waitresses in our local breakfast spots, about how they access healthcare,” he says. “I was amazed to nd that these individuals—who put in a lot of hours but make modest incomes—were trying to a ord premiums between $500 and $700 a month for an individual policy. Many couldn’t make ends meet and had to drop coverage or couldn’t a ord it in the rst place. It was a real reality check.” Fittingly, Gov. Rell chose a Hartfordarea diner for the Charter Oak kicko last summer. A waitress whom Starkowski met previously was a special guest and the rst o cial applicant for Charter Oak Health Plan. In addition to bringing access to healthcare to the working uninsured, Charter Oak provides a continuity of services for former HUSKY A and HUSKY B participants, Starkowski says. “As an example, there are about 1,400 people who lose HUSKY A coverage every month because they have exhausted their one year of transitional Medicaid,” he says. “While children and teenagers can move to HUSKY B, the approximately 400 to 500 parents or caregivers in that number had no a ordable health services option until Charter Oak was established.” Starkowski maintains that Charter Oak 14 NOVEMBER 2008 is not trying to ll the role of the employer in terms of providing healthcare. “There is still personal responsibility for an individual to participate in the nancial requirements of their healthcare,” he says. “We’re not trying to assume the employer’s responsibility. We recognize that Connecticut has a robust employer-sponsored insurance rate, which is fairly high compared with other states.” salary of the individual,” he says. “It’s a strain on both sides.” Individual market competition There is growing competition in Connecticut and around the nation in the sale of individual policies. As of 2007, 17.9 million Americans under age 65 had individual policies, according to the Employee Bene t Research Institute. Gov. M. Jodi Rell appointed Michael P. Starkowski as Commissioner of the Connecticut Department of Social Services in January 2007. From 1993 to his nomination as Commissioner, the career public servant was Deputy Commissioner for Administration at DSS, which he joined upon graduation from Central Connecticut State University with an accounting degree in 1974. He was an architect of his state’s Medicaid/ SCHIP program—the HUSKY Plan—in the late 1990s. Fittingly, the Commissioner is an avid Connecticut Husky basketball fan and memorabilia collector, with his of ce looking a bit like a UConn hoop museum. He and his wife, Karen, have two daughters and three grandchildren. “I feel privileged to have my family’s healthcare needs covered under the state employee bene t package,” Starkowski says. “Having the health security is so important as you raise your children.” In fact, according to the results of the O ce of Health Care Access (OHCA) 2006 Household Survey, in 2006, most Connecticut residents were insured (93.6%) through either public or private coverage. The uninsured increased slightly from 5.8% to 6.4% from 2004 to 2006, and employment-based coverage increased to 66.5% from 64%. Even though Connecticut has a statistically small percentage of uninsured, they still face problems accessing care, Starkowski says. The public-private model’s goal is to provide coverage for every adult. “Employers in Connecticut have really stepped up to the plate to try to provide access to health insurance, but it’s a strain for many, especially small businesses, to contribute substantially toward the premiums and the cost of healthcare and the actual “As the size of the commercial group health insurance sector remains at insurers must seek growth elsewhere, and individual policies are a major example of that,” says Peter Kongstvedt, MD, an independent advisor based in McLean, Va. “People who lose coverage through work, people who are self-employed or who work for small companies without bene ts, and people who have lost coverage because of job loss are all potential candidates for individual policies.” For the long-term stability of the program, it is important that Charter Oak not draw people away from commercial insurance plans, says Tom Kelly, president and CEO of Aetna’s Medicaid business unit. Aetna Better Health is one of the Charter Oak managed care organizations. “Aetna does not believe that public pro-

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Managed Healthcare Executive - November 2008

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