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Thursday, June 19, 2008

Advocates criticize health plan

By Mary E. O’Leary
Register Topics Editor
NEW HAVEN
— Advocates for the disabled are charging that the proposed Charter Oak health plan is discriminatory, and are asking that the state amend it before contracts are signed with providers.
In a continuing fight over terms of the insurance, 12 advocacy groups wrote to Michael Starkowski, commissioner of the state Department of Social Services, Tuesday warning him that the mentally and physically chronically ill are a protected class.
"Purposefully excluding a sizeable portion of the uninsured, the chronically ill, from a state program that professes to provide coverage to the uninsured, implicates a gross constitutional violation," the letter says.
They point to a 2007 memo from state consultant Steve Schramm of the need to put limits on benefits "to avoid selection issues associated with the chronic users of those services."
The groups are concerned with the $7,500 drug benefit limit, the $4,000 medical equipment limit and lack of equal coverage for mental and physical conditions, all of which they say adversely impact the chronically ill.
But David Dearborn, spokesman for the Department of Social Services, said the insurance, rather than discriminating, welcomes "people with disabilities and chronic illness with open arms" because it "will have absolutely no exclusion for pre-existing medical conditions."
"The state of Connecticut is saying, ‘Come into the program, whether you are healthy or not. ... We will offer you affordable, credible coverage,’" Dearborn said.
Asked whether they plan to sue the state, should the insurance not provide for mental health parity and increase other benefits, Jennifer Jaff, executive director of Advocacy for Patients with Chronic Illness, said she hopes the state will consider their arguments.
"It is our hope that the state will look at this from a new perspective," Jaff said. She said she hoped the state would do the right thing "and we won’t have to consider other options."
Jan Van Tassel, executive director of the Connecticut Legal Rights Project, said they have been waiting for a dialogue to occur with state officials, but it has not materialized.
"We think the discrimination is blatant and we want to get a clear answer from them (state officials)," she said. Van Tassel said they would look to locate plaintiffs, if they must.
Van Tassel said there is a huge inconsistency between how Connecticut sees itself as a leader in transforming the mental health system and in fighting discrimination and in the lack of mental health coverage under Charter Oak.
Attorney General Richard Blumenthal said he was sympathetic to their concerns.
"In legal terms, any arrangement that excludes recipients or residents because of chronic mental or physical conditions would raise constitutional and fairness issues," he said. . My hope is that we can resolve these issues," he said. "I understand the potential merit of their points."
Dearborn said limits on coverage apply to everyone, not just the disabled, in order to keep costs down, while the advocates say the chronically ill are the only ones adversely affected.
"Everyone who knows health insurance knows that; there has to be a balance of benefits and cost to make the plan feasible and affordable. This is especially important during this time of fiscal difficulties," he said.
Mary E. O’Leary can be reached at 789-5731 or moleary@nhregister.com.

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