Charter Oak offers affordable access

John (not his real name), 47, a part-time manufacturing worker from Torrington, Conn., with no employer insurance and numerous medical bills, couldn't afford commercial insurance. He had no medical conditions that would qualify him for a state high-risk program and was not eligible for Medicaid. He embodied the reality of the working uninsured, which accounts for some 38 million of the 47 million uninsured in the United States.

John was one of the first citizens in Connecticut to enroll in Charter Oak. With sliding-scale premiums ranging from $75 to $259 and annual deductibles ranging from $150 to $900, Charter Oak was perfect for him.

Gov. M. Jodi Rell proposed the $11-million state-subsidized Charter Oak plan for uninsured adults, like John, ages 19 to 64, who don't qualify for other programs.

"When Governor Rell discussed her vision for addressing the ranks of the uninsured in this state, there was no question that I was energized to help develop the details," says Department of Social Services (DSS) Commissioner Michael Starkowski. "There hadn't been a lot happening on the national scene in terms of addressing the uninsured."

Charter Oak benefits are delivered by a commercial health insurance model, with deductibles, copayments and coinsurance. Plan participants are enrolled in Aetna Better Health, AmeriChoice by UnitedHealthcare or Community Health Network of Connecticut.

"CMS has actually hardened its stance on some of the creative plans that are being proposed by states that look for federal financial assistance to address the uninsured," Starkowski continues. "Governor Rell decided that Connecticut would take the initiative to do something positive, on our own if necessary. As the administration changes, we'll continue to work with CMS and see if they will help us address the problem in terms of financial participation-as is the case in Medicaid and SCHIP."

A perfect fit

Charter Oak complements the DSS's two HUSKY (Healthcare for UninSured Kids and Youth) programs, which provide healthcare to children, regardless of family income. HUSKY A covers children up to age 19 and eligible parents/relative caregivers as well as pregnant women up to 185% of the federal poverty level (FPL). HUSKY B covers only children up to age 19 in households earning more than 185% of FPL. Children in households earning 300% of FPL or more can be covered at the full state-negotiated group-rate premium. Transitional Medicaid is offered for one year to parents/relative caregivers in HUSKY A who lose income eligibility.

"We wanted to fill that gap for the uninsured in Connecticut-those adults who lose HUSKY coverage or who aren't eligible in the first place," Starkowski says. "Many workers don't have access to employer-sponsored insurance. There are also situations where the full-time worker has been given access to insurance by the employer, but the coverage is still unaffordable."