PROVIDENCE – In the culmination of months of public meetings and discussions, Lt. Gov. Elizabeth H. Roberts today unveiled an eight-piece health care reform package that aims to expand insurance coverage while containing key drivers of spending growth.
The package – dubbed the “Healthy Rhode Island Reform Act of 2008” – is far less ambitious than the recent efforts in Massachusetts, Vermont and other states, but it is comprehensive and would affect every stakeholder in the system from employers to consumers to providers to insurers to the government.
The lieutenant governer was joined in her State House presentation by R.I. Health Insurance Commissioner Christopher F. Koller; Warwick Mayor Scott Avedisian; and several key legislators who are sponsoring the eight bills in her reform package, including Senate Majority Leader M. Teresa Paiva-Weed, D-Newport (House Majority Leader Gordon Fox, D-Providence, couldn’t make it but is also a key backer of the plan, Roberts said). Also present were business leaders and health care leaders including NetCenergy President Donald Nokes, a member of the board of the Rhode Island Business Group on Health, and Steven DeToy, lobbyist for the Rhode Island Medical Society.
Any entity that employs more than 10 full-time workers would be required to pay a “health security assessment” equal to 8 percent of the taxable wage base for the state employment security system. Roberts estimated the assessment at $1,000 per year per employee.
Those payments would be offset in part or in full by the actual health insurance premiums paid, so most employers who already insure their workers would not be affected. The money collected from the others would be used to support efforts to cover the uninsured.
Roberts is also proposing a requirement that anyone earning 400 percent or more of the federal poverty level – currently, $40,840 for an individual, $82,600 for a family of four – must purchase insurance, starting in July 2009, when a new Health Insurance Access Hub would open for business.
The Hub, for its part, would provide a Web-based clearinghouse for individuals and small businesses to buy coverage, easily comparing rates and coverage levels available from different insurers. (Koller said the Hub would be like “Travelocity for health insurance.”)
To expand consumers’ options, Roberts’ plan would allow any insurer licensed in neighboring states to offer coverage in Rhode Island without obtaining a separate license.
To cover more young people, who make up a substantial chunk of the uninsured, Roberts would make anyone younger than 25 eligible for coverage under their family’s plan, regardless of whether they are students. (Students in that age group are already eligible for such family coverage.)
And to address the main drivers of health care spending growth, Roberts would require all health plans – starting with those financed by the state, including Medicaid, as well as public employee coverage – to emphasize primary care; require care management for chronic conditions; and realign provider reimbursements to reflect these priorities.
None of this, Roberts said, would require additional state spending. But, she added, it would be crucial that RIte Care – the state health insurance program for low-income children and families, which she isn’t seeking to expand at this time – be continued at its current level, rather than being cut as Gov. Donald L. Carcieri proposed in his recent budget plan.
Yet before the state invests in expanding public coverage, she said, it needs to address the factors causing costs to rise and forge a broader agreement on Rhode Island’s health care priorities.
“This is not one of those problems that will go away if we ignore it,” Roberts said. “It will actually get worse. People have told me that we cannot afford to begin reforming health care in Rhode Island this year. I am here to tell you that we cannot afford not to.”
online editions of the Feb. 18 Providence Business News.
Additional news from the lieutenant governor’s office is available at www.ltgov.ri.gov. Once her reform package’s eight bills are filed, details will be available from the R.I. General Assembly – along with other information, including the House and Senate daily calendars and listings of measures introduced each day – at rilin.state.ri.us.
