The Division of Insurance held a hearing today on its emergency Young Adult Plan (YAP) regulations. YAPs are private health plans to be offered through the Connector only to persons between ages 19 and 26. The Division worked with the Connector to design the benefit package these plans must include.
Among those testifying were members of Affordable Care Today (ACT!!) Coalition (read our testimony here). HCFA’s Lisa Kaplan Howe opened our testimony by thanking the board for their hard work and highlighting coalition concerns. Top among ACT!!’s concerns is the inclusion of annual benefit caps. ACT!! believes these caps undermine the purpose of insurance and we worry they put young adults who have accidents or are diagnosed with serious illnesses at risk of financial ruin and barriers to care. The coalition asked that the regs be amended to exclude these caps no later than July of 2008.
Concerns about annual benefit caps, cost-sharing and deductibles were echoed by Mindy Cohen of the Children’s Health Access Coalition, Lorianne Sainsbury-Wong of Health Law Advocates, Kathy Bitteti of the Artists Foundation, Carol Pryor of the Access Project and Steve D’Amato. Speakers shared stories of devastating experiences of individuals with student health insurance plans that had annual caps similar to those allowed in YAPs. (The Access Project recently released a report on these plans entitled “Not Making the Grade” and Dr. Jay Himmelstein, who submitted written testimony, recently wrote an article about his niece’s problems with a student health plan)
Two young adults shared personal stories reflecting their concerns with annual benefit caps and other aspects of the regs. Ben Healy is 25 and looking for insurance. He told the Division he hopes to find insurance that provides him with preventive and catastrophic care. These are two things YAPs do not provide.
Vanessa Furtado shared her lesson about the importance of catastrophic coverage she recently learned. When she was a “healthy” 24 year-old she chose the least expensive health plan her employer offered. She ended up being diagnosed with a heart condition and a heart infection, resulting from complications of not being able to afford to go to the dentist for two years. By the time she was released from the hospital 12 days later, and after surgery, she had a $52K hospital bill. This did not include costs for months of follow up care she needed. Luckily, her plan did not have a benefit cap. The $50K permitted annual caps would have compromised her health and finances. She asked the Division to protect young adults from annual caps that can have severe long term consequences.
Also testifying were Tom Nyzio of the Massachusetts Association of Health Plans, who thanked the board for their hard work and offered MAHP’s support of the regulations and Bob Carey from the Connector.