‘Not much changing,’ including cost, Roberts says of health care changes
Lt. Governor Elizabeth Roberts is on a campaign to get the word out about the pending changes in health care, as the Rhode Island Health Benefits Exchange and the Affordable Health Care Act kick in, with registration starting Oct. 1.
But, judging from her presentation to the Warwick Rotary Club Thursday, small businesses and their employees aren’t going to see a whole lot different. That may be the case, yet she assured, “You’re going to hear a lot about it in the next six weeks.”
Roberts isn’t alone in the effort to inform the public. An intensive advertising campaign is set to kick off. Material has been printed and Power Point presentations are at the ready. Offices, with people who can answer questions about the plans, are in the process of being setup.
“Our big concern is that people don’t know about HealthSource Rhode Island,” said Roberts.
Starting Oct. 1, people will be able to use HealthSource RI to compare health plans and determine whether they are eligible for tax credits. Actual coverage starts Jan. 1, 2014. And, according to the website, HealthSource will allow employers to “dramatically reduce” administrative costs, “while at the same time increasing the choice your employees have to get the health care they need to remain productive.”
A brochure distributed at Thursday’s meeting says employers will have the option of covering their share of the insurance premium and allowing employees to apply it toward any of the plans on the HeathSource RI’s small group marketplace. Small businesses are defined as having fewer than 50 employees and may be eligible for a tax credit that could cover up to 50 percent of health plan costs.
Roberts talked for about 20 minutes before fielding questions for another 10 minutes. Her presentation was concise and she stuck to the topic, although there were a few familiar faces in the audience who she acknowledged.
“We are not creating a government-run program,” she said at the outset.
Three insurers – Blue Cross, United and Neighborhood – will offer plans at the start, with Tufts coming into the market next year. The aim of the exchange is to enable users to select a plan that fits them while being grouped with a large enough pool that costs are reduced. Roberts said HealthSource would offer “one-stop shopping that will open up the market to look at options.” She said there would be 25 plans to select from.
On Tuesday, HealthSource announced the final approval of plans and rates that will be offered through the exchange when open enrollment begins for individuals and small businesses on Oct. 1.
HealthSource RI has signed agreements with the three insurance carriers to offer 28 plans through the exchange – 12 on the individual market and 16 through the Small Business Health Insurance Options Program (SHOP). Blue Cross and Neighborhood Health Plan will offer plans on the individual market, and all three carriers will offer plans through SHOP.
According to the release, the plans “are the result of HealthSource RI’s extensive negotiations with the carriers, and include a ‘full employee choice’ model through SHOP. All plans offered through HealthSource RI include coverage for doctor visits, prescription medications, hospital stays, preventative screenings and additional essential health benefits. All plans also feature maximum out-of-pocket limits for major medical expenses.”
Roberts said businesses would still have their partnerships with their brokers.
It doesn’t sound like a lot is going to change.
“What you are going to see,” Roberts said, “is going to be a lot of what you see right now.”
Unfortunately, that also appears to be the case regarding cost, too.
Roberts noted that health insurance is one of the biggest costs faced by people. She said the plans are “all going to cover the same basic things.” As for the issue of affordability, she said that remains the challenge.
Costs topped the list of questions and Roberts said one of the issues being looked at is the number of hospital readmissions. She pointed out that, in most business relationships, when a job isn’t properly preformed; the provider isn’t paid or is expected to fix the problem at no additional cost. In a hospital, however, the patient [in most cases the insurer] is expected to pay to correct the problem. Roberts said insurers are looking at the percentages of readmissions in comparing and contracting with hospitals.
“The best way to lower health care cost is to be healthy,” she said.
A community forum with Mayor Scott Avedisian will be held Sept. 11 from 8:30 to 10 a.m. at New England Institute of Technology on Post Road, Warwick.