Mini-meds mandated in Massachusetts?

Massachusetts’ Commonwealth Health Insurance Connector is doing its best to ensure the availability of affordable, high-quality health plans. For young adults, they’ve opted for an enhanced version of the existing student health plans, which have been mandated for almost 20 years. The plans are cheap: as low as $119 per month without drug coverage.

There’s a catch, though. The plans have annual coverage caps of $50,000 or $100,000. That’s higher than the $25,000 to $50,000 caps of the student plans, but it won’t take a seriously ill young adult (or their premature baby) to run up a bigger bill than that in Beantown.

Patricia Walrath, co-chair of the Legislature’s Health Care Financing Committee told the Boston Globe:

We thought this was one place where we could be a little experimental, because they are a very low-risk population.

But the Access Project thinks differently and issued a report critical of the plans. Plan co-author Stephen D’Amato says:

[T]he main purpose of insurance is to protect people in those rare instances when you have huge costs. Allowing these caps is duplicating a mistake that was made nearly 20 years ago. It’s going to destroy some lives

In a perfect world –or actually in any other OECD country– $119 per month would be enough to pay for comprehensive coverage for a young adult. Here, though, it isn’t. As a result, there’s a tradeoff between an affordable premium, coverage for routine services, and coverage for catastrophic costs.

I’ve written before about Mini-Meds –policies that offer limited coveraged, with caps much like these new Massachusetts plans. In some ways they are odious –almost the opposite of insurance– but they do provide access to the health care system and take away the worry of being saddled with $10,000 or $20,000 in medical debts. A debt like that can seem almost as catastrophic as a $1 million debt to people of limited income.

I don’t object to the capped plans for young adults. First, keeping the premiums somewhat reasonable will increase compliance with the mandate and increase the attractiveness of living in this state. Second, if debts get too high there’s always bankruptcy protection. Young adults have time to start over and since the hospitals will have such a high percentage of insured patients they should be able to suck up some of the losses without whining too much.

May 29, 2007

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