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Some question Roberts’ health-care plan

03:31 PM EST on Wednesday, February 13, 2008

By Cynthia Needham

Journal State House Bureau

PROVIDENCE — It was the moment Lt. Gov. Elizabeth Roberts has waited for.

Legislative leaders, advocates and medical professionals packed the State Room yesterday to support her health-care reform plan, a package of bills that they say “starts the conversation” about changing the state’s health-care system, offering more affordable and more accessible care.

But many of those in the crowd also questioned the finer points of Roberts’ eight-part proposal. Is it fair to require small businesses to purchase health coverage or face $1,000 yearly penalties per employee? What about Rhode Islanders who can’t afford insurance and don’t qualify for the state’s RIte Care program; how will they be covered? What can this state do to avoid the cost overruns that have plagued the Massachusetts program?

In this, the highlight of Roberts’ one-year tenure as lieutenant governor, she acknowledged that her proposal does not answer every question. “What is unique about this package is that it calls on policymakers, state officials and citizens to work together to establish the infrastructure for change and set clear priorities on strict time lines before new public funds are invested,” she said.

In other words, it’s more of a blueprint than a precise set of mandates.

Beyond requiring business owners with more than 10 employees to purchase health care for their workers or pay fees, the plan would obligate individuals making at least $40,840 and families making $82,600 to purchase insurance. It also creates a HealthHub, a quasi-public agency to help coordinate purchasing and regulate plans, much like the Massachusetts Connector Authority.

The second part draws on familiar preventative-care strategies, creating a statewide database that tracks health trends, shoring up access to physicians and standardizing care of chronic conditions, to ensure more “health care” and less “sick care.”

Supporters yesterday praised Roberts’ attempts to keep the reform process open through a recent series of public meetings, and her willingness to avoid rush decisions.

But some say the real test will come in how those details are ironed out.

Health Insurance Commissioner Christopher F. Koller said it’s important to delineate how individuals who can’t afford their own insurance can purchase it, especially if the state plans to fine businesses that don’t provide coverage.

Karen Malcolm, executive director of the advocacy group Ocean State Action, said she worries that opening the market to for-profit insurers from Massachusetts and Connecticut without requiring local licensing may do more for corporate profits than for competitive policy pricing.

And while the business community has pushed in recent years for more affordable health-care options, Terrance S. Martiesian, lobbyist for the National Federation of Independent Business, said he is “concerned for the business sector that this will be another expense that’s added on” in a stagnant economy.

Among the biggest backers of the Roberts plan are the legislative leaders who must approve each part of the legislation. House leaders offered particular praise with Majority Leader Gordon D. Fox planning to sponsor parts of the legislation and Finance Chairman Steven M. Costantino calling the package “a template for the future.”

“I think this is the year you start the discussion,” Costantino said. “You start it now and you have a year behind you working out all these details. [Next year] if things change [with the state’s deficit situation] you’ve done all the groundwork on something like this.”

The groundswell of support for Roberts’ ideas will prove critical as the plan moves forward. In Massachusetts, the quick adoption of that program was due, in part, to the fact that it was crafted by the Democratic-controlled legislature together with former Gov. Mitt Romney, a Republican. Governor Patrick has publicly supported the plan as well.

Rhode Island Governor Carcieri yesterday declined comment through a spokesman, saying he hadn’t yet reviewed the proposals’ details.

Now Roberts says she’ll take her ideas on the road to try and drum up public support through a series of town hall-style meetings with the goal of helping Rhode Islanders understand how the changes could affect them.

She’s also promised to fight Governor Carcieri’s plan to cut thousands of children from the state’s RIte Care program, calling it a “short-term reaction” to attack the state’s massive deficit.

From there it will be up to the General Assembly to debate each of the eight bills and keep the health-care conversation moving.

cneedham@projo.com

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