PROVIDENCE – The most ambitious parts of Lt. Gov. Elizabeth H. Roberts’ health care reform package, which sought to put Rhode Island on a path to universal coverage while promoting quality and affordability, did not make it through the General Assembly this year, though other parts did.
Roberts, a leader in health care policy in the state for several years, had put together an eight-part legislative package that stopped far short of Massachusetts’ 2006 health care reform, but did contain provisions modeled after that reform.
One bill would have required any entity that employs more than 10 full-time workers to pay a “health security assessment” equal to 8 percent of the taxable wage base for the state employment security system, about $1,000 per employee, with the payments offset in part or in full by actual health insurance premiums paid.
Roberts also sought to require anyone earning 400 percent or more of the federal poverty level – or $40,840 for an individual, $82,600 for a family of four – to purchase insurance starting in July 2009. To help them buy coverage, the reform plan sought to create a Web-based Health Insurance Access Hub that would allow them to compare rates and coverage levels.
Roberts also wanted to make anyone younger than 25 eligible for coverage under their family’s plan, regardless of whether they are students.
In addition, Roberts proposed changes to the health insurance regulatory system to make it easier for other insurers to come into this market, and she proposed measures to make health plans in the state, starting with those financed by the state, emphasize primary care.
Roberts promoted her plan through public meetings all across the state, and she reached out to stakeholders across the health care sector, employers and advocates. But she also said from the start that she had tried not to be too ambitious this year because of the state’s budget crisis, and she made a point of breaking up the plan into eight pieces so even if one part didn’t make it, other parts could still be approved.
Ultimately, four elements of the plan made it through:
• A “Regional Health Insurance Market Initiative” will allow insurers licensed to do business in other New England states to sell coverage in Rhode Island without having to go through the full licensure process.
• A “Quality and Value Database” will provide cost and quality information for health care consumers.
• The “Healthy R.I. Strategic Plan and Chronic Care Management Plan” will steer health plans toward compensating doctors for keeping patients healthy through preventive care and chronic disease management.
• A Joint Legislative Task Force to be co-chaired by Roberts, a state senator and a state representative will look at ways to continue reforming the health care system.
Neither the employer assessment nor the individual mandate were approved by the Assembly.
“Over the past nine months I have met with hundreds of Rhode Islanders, to hear from the people most affected by the problems we confront in our health care system,” Roberts said in a news release. “One thing I’ve heard loud and clear is that inaction on health care reform is not an option. The passage of this legislation is a significant step, but the true work lies ahead. Now I am reaching out to the health care industry, policymakers, and everyday Rhode Islanders to drive these changes forward.”
More information about Roberts’ plan is available at www.ltgov.ri.gov.
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