Connector Weighing Tough Choices on Minimum Coverage

December 1, 2006

Commonwealth Care Update

The Commonwealth Care Connector Authority announced on Wednesday that more than 14,000 low-income individuals have enrolled into a program, which features no deductibles or premiums, since program inception back in early October. The program is currently designated for individuals with incomes below 100 percent of the federal poverty level. Of the roughly 60,000 people eligible for the program, 50,000 have been previously associated with the state's uncompensated care pool.

On January 1, 2007, the program will expand to cover those earning up to 300 percent of the federal poverty level and in the spring, the Connector will take additional steps to aid the state's 200,000 uninsured residents acquire coverage through commercially available plans, which are under development.

Minimum Credible Coverage Debate Heats Up

The board met yesterday to discuss the commercial plans that will be presented to uninsured state residents in the spring. The hot topic was on "minimum credible coverage" standards, which define benefits for people when selecting a health plan. This comes after the board indicated that they might allow certain plans that do not offer drug coverage.

The board also faced some additional distress from Sen. Richard Moore and Rep. Patricia Walrath, who in a letter to the board stating that the Connector has misrepresented the State Legislature's intent by suggesting unrealistically low premiums for the commercial plans.

The Connector Policy Committee suggested that the board set coverage to include prescription drugs, limited out-of-pocket expenses and balanced premiums. Executive Director, John Kingsdale, stressed an urgency to define the minimum credible coverage parameters and plans to issue a Request-for-Response in December, which carriers will have to respond to regardless of not knowing the minimum standards.

According to board statistics, 50 percent of the state's uninsured population is between the ages of 19-34 and it is estimated that 200,000 uninsured individuals are not currently eligible for the Commonwealth Care plans.

The meeting adjourned with the board acknowledging that they were not able to define the minimum credible coverage as of yet and will resume discussion to reach a final decision in January. The Request-for-Response will include a request for carriers to submit plans that set a minimum premium at $320 per month and plans that may or may not include drug coverage.

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