Wednesday, March 27, 2013
What can Charter Oak teach the CT health insurance exchange?
A comparison finds lower consumer costs in the current Charter Oak plan than the Access Health CT (the CT Health Insurance Exchange) standard silver plan. Governor Rell created Charter Oak almost five years ago for the same purpose as the exchange – offering affordable, decent coverage options for CT’s uninsured. While Charter Oak premiums started out at an affordable $257 monthly premium, because of high cost sharing and limited provider panels, the plan grew less attractive to healthier people, driving enrollment down by 61% and premiums up to $589 monthly. It never came close to meeting expectations or addressing the needs of CT’s 300,000 uninsured. Unfortunately the exchange is poised to make the same mistake. Costs in the exchange standard silver level plan are higher than Charter Oak for most services. The total out of pocket maximum is $1,800 in Charter Oak but $6,000 for in-network care and $12,000 for out-of-network care in the exchange. CT’s exchange and Board need to sharpen their pencils to keep costs down for uninsured consumers. One of the best tools for that is active purchasing – negotiating rates with insurers – used with success by other states and most large groups. A bill directing the exchange to actively purchase coverage on behalf of consumers and small businesses is moving through the legislature.