In her latest Exchange Watch story on Columbia Journalism Review Trudy Lieberman poses the five big questions that every healthcare reporter should be asking. At the top of her list is the question advocates in Connecticut have been focused on, “Will policies be affordable?” While there will be subsidies to help many individuals and families pay for premiums, insurance policies sold by Access Health CT will also have deductibles and co-pays. As Lieberman points out, Connecticut’s exchange board recently, “increased the annual deductible from $2,500 to $3,000 for the ‘silver’ plan, which is designed to cover 70 percent of medical costs.” And the most recent draft of the standard plan had a proposed $400 prescription drug deductible and $30 and $45 office visit co-pays.
For those who currently buy their own insurance, these deductibles and co-pays in the model plan are big improvements over their current policies. Even for young people who are uninsured now, the large majority will receive premium subsidies and will not suffer from “rate shock,” like America’s Health Insurance Plans (AHIP) would like them to believe.
Even though this higher deductible comes into play only with hospital admissions, outpatient surgery and skilled nursing admissions and there are caps for total out-of-pocket costs, this plan still leaves the sickest as potentially the most vulnerable to having their costs spiral out of control. And for the HUSKY parents between 133 percent and 185 percent of Federal Poverty Level (annual income between $25,975 and $35,317 for a family of 3) who may lose their HUSKY coverage, even with extra out-of-pocket protections, copays and deductibles will be too high and many are projected to become uninsured.
On Monday the board will hold a special meeting to finalize their recommendations for the standard plan. Meetings are open to the public and may also be accessed by phone. There is also an opportunity for public comment at the beginning of the meeting.
Jill Zorn is the senior program officer at Universal Health Care Foundation of Connecticut.