By: Felice J. Freyer
Notices have gone out to 6,500 people, alerting them that their coverage under the state’s RIte Care program will end this year.
These people are all parents of children covered by RIte Care; the parents, but not the children, were cut from the rolls by a legislative decision.
The parents will be encouraged to enroll in private insurance through HealthSource RI, but they will have little time to make a complicated decision: the notices are going out only one month before the Dec. 15 deadline to choose a plan.
The General Assembly last June voted to save $6 million by changing the eligibility rules for RIte Care, the state health plan for poor families. Under the previous rules, parents of children on RIte Care could also enroll if their annual income was below 175 percent of the federal poverty level, or $34,000 for a family of three. The General Assembly changed the cutoff to 133 percent of the poverty level, or $27,000 for a family of three.
These people can buy their own insurance through HealthSource RI, the Obamacare insurance exchange. They will qualify for federal subsidies to lower their premiums. The state is also offering additional premium assistance for certain plans.
But the plans on HealthSource RI all have deductibles, ranging from $500 to $6,350 for single people, as well as co-pays for services. As a result, even those facing little or no premiums could bear substantial new medical costs. RIte Care, which is part of the state Medicaid program, has no co-pays or deductibles.
The letter, which people started receiving on Friday, asks enrollees to fill out a questionnaire to see if they might still qualify for Medicaid; this could be true if their income has gone down or they are pregnant or disabled, for example. A followup letter will encourage them to choose a plan on the exchange.
“The parents who are being hit with the change are going to need individual help,” said Linda Katz, co-founder and policy director of the Economic Progress Institute, a nonprofit policy and research organization concerned with low-income Rhode Islanders. “We’re very, very concerned that we’re going to dump 6,500 people into a system where there is no capacity to help them.”
This week, the institute’s Health Coverage Project wrote to Governor Chafee, legislatives leaders and the Department of Human Services urging them to delay implementation of the change until next year.
But Medicaid Director Elena Nicolella said that any delay would require a legislative change. And she said the state is working hard to communicate with every affected parent. Because their children remain in RIte Care, they will not be hard to track, she said.
The HealthSource RI contact center, the enrollment counselors known as “navigators,” as well as state human services field offices and the insurers will all be helping people make the transition, she said.
The HealthSource RI contact center will call every one of the parents during the week of Dec. 9, Nicolella said.
Katz noted that parents will have to choose insurance before they even know how much state premium assistance they will get. The assistance program’s eligibility process has not been integrated into the HealthSource RI software, and applications will be done on paper. The regulations governing the state premium assistance program are not yet in force; they will be presented at a Dec. 3 hearing.
Nicolella said that the state would be able to give people an estimate of the amount, and is also asking insurance companies not to drop people who can’t pay the premiums while waiting for the state assistance.
A little more than half the parents had been paying premiums of $61 a month to enroll the entire family in RIte Care. These parents will no longer have to pay the premium to keep their children in RIte Care, but will likely face premium costs for themselves.
“Are we concerned about these parents? Absolutely,” said Jane Hayward, executive director of the Rhode Island Health Center Association. The association’s members provide medical services to many of those affected. In addition, it has the contract with HealthSource RI to run the navigator program.
“Are we concerned about our capacity to assist them? Absolutely,” Hayward continued. “We are working very closely with [the state] and HealthSource RI to try and find the appropriate solution to trying to move this many people in such a short period of time.”
Affected parents with questions are urged to call the HealthSource RI contact center at (855) 840-4774.