Lindsay Lang sees trouble coming in maintaining health insurance for some Rhode Islanders, and she wants state lawmakers to act before it’s too late.
Lang, the director of the state-run health insurance marketplace HealthSource RI, is calling on legislators to enact a policy that would transition holders of Medicaid policies they’re temporarily entitled to during the pandemic into low-cost plans available through Rhode Island’s public exchange.
The country’s COVID-19 public health emergency allowed the state to provide Medicaid plans that automatically renewed on an annual basis, but that will be over by the end of this year, and many people at the lower end of the income spectrum will be in for a rude awakening if nothing is done to make sure they continue to be insured, she said.
“We’re really concerned about that,” Lang said. “Folks have become accustomed to that level of federal subsidy, and that’s a huge swing in someone’s monthly and annual budget that they may not be aware is coming.”
Lang shared her thoughts on the situation during the first of two panel discussions at the Providence Business News Spring 2022 Health Care Summit held on April 6 and attended by about 150 people at the Providence Marriott Downtown.
Lang’s recommendation: the state should enroll those who received Medicaid as a result of the public health emergency into a plan through HealthSource RI and pay for their first month’s premium.
“What [this transition proposal is] going to do is sort of hit the pause button and allow an extra month for folks to make sure they have coverage, figure out what happened, understand the differences … and hopefully stay covered,” Lang said. “Ultimately, it would ensure there is continuity of coverage, and no one goes without coverage unknowingly or by mistake.”
Lang said this can be done by using a portion of Rhode Island’s $1.13 billion in American Rescue Plan Act money. A $339,000 allocation has been included in Gov. Daniel J. McKee’s fiscal 2023 budget proposal.
“We think that’s a great way to use those one-time dollars … to really have an impact as we hopefully transition out of this pandemic,” Lang said.
Dr. Amy Nunn, another panelist, said ARPA provides an opportunity for Rhode Island to make a difference in some of the most glaring health disparities in the state.
“We have an opportunity to address some major, major problems with the ARPA spending that we would otherwise perhaps not be able to afford,” said Nunn, executive director of the Rhode Island Public Health Institute.
Nunn noted that Rhode Island’s childhood obesity rates “are on par with those of the southern United States,” and the trend is disproportionately impacting Rhode Island’s Latino population, she said.
On top of that, Rhode Island doesn’t have a plan to address its hunger crisis, Nunn said. One in 6 families is “food insecure,” which means a child goes hungry at least one day a month, she said.
“These problems are alarming,” Nunn said. “We’re now compelled with the ARPA dollars to address our basic needs.”
Nunn said it is “extremely” important for Rhode Island to increase its Medicaid reimbursement rates.
“This should be an absolute top priority,” Nunn said. “Health institutions are experiencing tremendous inflationary pressure for wages. … We have managed to hold on to our mid-level and senior-level folks, but the churn at the bottom means … people are just getting burned out.”
Panelist Dr. Christopher Ottiano, Neighborhood Health Plan of Rhode Island medical director, said it’s crucial that stakeholders work together to improve health and offer cost savings to policyholders. Part of that process, he said, is collaborating to create cost efficiencies and overcome other barriers. “No one entity in the state of Rhode Island can do that by themselves,” he said.
Ottiano said Neighborhood Health has 25,000 or 30,000 members that came through the state-run health insurance marketplace. He said the flexibility of access to care through HealthSource RI, created in 2013 as a part of the federal Affordable Care Act, has been important during the pandemic as policyholders have lost jobs, found new work and gone on and off of Medicaid.
Ottiano spoke about the importance of ensuring members are staying connected with their health care throughout the pandemic.
“You’ve got to be in the neighborhoods, you’ve got to be in the churches, you’ve got to be in the barbershops,” Ottiano said. “You probably saw, we were bringing vaccinations to the doorsteps. That’s what we learned. They used to say all politics is local. All health care is evolving and becoming local.”
Dr. Robert MacArthur, chief medical officer at Commonwealth Care Alliance, agreed.
While virtual care has been important during the pandemic, going into people’s homes remained vital.
“We still did tens of thousands of face-to-face visits,” MacArthur said. “We paid hazard pay for the first six months of the pandemic. We were able to have no members get infected, and no staff get infected as a result of those. The reality is you make the commitment. It’s part of what happens. Health care is very personal.”
Marc Larocque is a PBN staff writer. Contact him at Larocque@PBN.com.
