Insurance News

State may not boost healthcare premiums

Posted on: March 31, 2009

Tens of thousands of residents who receive state-subsidized healthcare will avoid any increase in monthly premium costs this year, and some may even pay less, under a plan to be voted on today by state regulators.

Secretary of Administration and Finance Leslie Kirwan confirmed late yesterday that her staff will recommend that the Connector Authority board approve the no-increase measure because of the “severe economic environment.”

The proposal has wide backing by board members, Kirwan said.

“This is bucking a trend that has been a really serious concern,” she said. Last year, regulators approved a 10 percent increase.

If approved by the 10-member board, consumers in the Commonwealth Care program, roughly 164,000 low-income people, will not pay more for their health insurance, starting July 1, if they choose the lowest-cost plans in the program.

Many who choose higher-cost plans may even see their monthly bills decrease, Kirwan said.

The state’s landmark health insurance initiative requires nearly everyone to have insurance, if they can afford it. The law allows exemptions for some residents who make too much to qualify for state-subsidized care but not enough to afford private coverage.

The board is expected to address these consumers as well today. It will decide on a formula that would be more generous this year than last in determining who qualifies for that exemption. People who do not have an exemption and who fail to buy health insurance, face a stiff tax penalty.

One of the state’s largest consumer groups applauded the news.

“There is only so much of a burden folks in this economic category can afford, and the administration is paying attention,” said the Rev. Hurmon Hamilton, senior pastor of Roxbury Presbyterian Church and president of the Greater Boston Interfaith Organization.

The affordability proposal before the Connector Authority board today is one of two major issues it will face. The other is a proposed joint venture by Caritas Christi Health Care network, affiliated with the Catholic Archdiocese of Boston, and a nonreligious company, Centene Corp., to provide insurance in the Commonwealth Care program.

The venture has drawn fire from both sides of the political spectrum because of questions about how the Catholic-affiliated entity will handle reproductive services, such as abortion, contraception, and sterilizations.

Abortion foes have decried the venture as an “appalling betrayal of Catholic principles,” while abortion rights and civil rights groups expressed concerns about hurdles low-income women may face in getting reproductive care after studying problems at a similar, though not identical, Catholic-affiliated managed care system in New York.

Caritas issued an initial statement saying its venture would cover a full range of “confidential family planning services,” but declined to elaborate. The Archdiocese later said it would not “in any way participate in actions that are contrary to Catholic moral teaching.”

Late yesterday, a spokeswoman for the Caritas-Centene venture issued an additional statement that explained how Centene handles similar situations in other states.

“If a provider does not perform certain medical services, that provider directs patients back to the health plan. Our health plans have local staff and 1-800 numbers available 24/7 for access to information on all services provided,” it said. “This number and information about all services are readily available online and in printed materials. In Massachusetts, we will apply these same procedures.”

Kay Lazar can be reached at klazar@globe.com

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© Copyright 2009 The New York Times Company

State may not boost healthcare premiums

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