Thursday, November 12, 2009

Enrollments Slow In State-Subsidized Health Insurance Plans

state insurance

As Congress debates a major health care proposal, Vermont's effort to extend coverage to the uninsured has hit some bumps.

Enrollment in state-subsidized insurance plans has slowed down in recent months. Analysts say the faltering economy made it harder for people to afford the premiums.

VPR's John Dillon reports:

(Dillon) Peter Sterling says there's tremendous interest in the Catamount health plan and other state insurance products.

(Sterling) "More and more people are going to our Web site. More and more people are going to the state's hotline, our hotline, more people are requesting applications from the state of Vermont, more people are calling the state's ombudsman, who are uninsured when they have questions about enrolling. Yet they're not signing up."

(Dillon) Sterling directs the Vermont Campaign for Health Care Security. It's his job to encourage people to get covered through the state plans.

But he says fewer people are signing up, probably because they can't afford even the state-subsidized premium.

(Sterling) "The rate in growth in enrollment in these programs has slowed significantly and we are concerned that this slowing in growth in enrollment has occurred at the same time that there is increased demand from the public for information about enrolling."

(Dillon) Steve Kappel is an independent health analyst who has also studied the numbers under a contract with the University of New England.

(Kappel) "The biggest surprise in what we're seeing with Catamount is just how many people cycle on and off the program. I think the original idea was it would be a place where people would sign on and maintain reliable coverage."

(Dillon) Kappel says people probably drop the Catamount coverage or fall back on another state plan when they can't afford the premius.

(Kappel) "These are folks who are living on pretty thin economic resources. So it may be that they can avoid the coverage for a couple of months, then the car breaks down. And that's why they drop off, and then they can recover from that, save back up again, get back on the coverage."

(Dillon) That matches what Peter Sterling says he hears on the phone when he talks to people about coverage.

(Sterling) "I would say everyday I talk to someone who says, ‘Well, I'm just going to have to think about this because I don't think I'm going to be sick, and I'm going to have to figure out how I'm going to afford this in the future.'"

(Dillon) Sterling says a subsidized Catamount plan for a family with household income of about $25,000 a year costs $110 a month.

(Sterling) "Which for health care, is really cheap for something that has an $800 out of pocket limit. The point is in real dollars. They're probably earning $13-$14 an hour. You take out taxes, that person's earning $10-$11 an hour. Where is that person supposed to come up with an extra $110? That's another 10 hours of work for them."

(Dillon) Catamount Health was launched in 2007 to extend coverage to the uninsured. The legislation had a goal of covering 96 percent of the state's population by 2010. It's very unlikely that the state will reach that target. And if the target is missed, the law requires the legislature to consider a public health plan and a mandate for individuals to get coverage.

The debate over an insurance mandate will also take place in Washington, as the national reform legislation comes up in the Senate.

For VPR News, I'm John Dillon in Montpelier.