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Linking HUSKY, Charter Oak Programs Proves Painful

Susan Campbell

November 30, 2008

Early this month, Bethany Rebstock had an abscessed tooth that hurt all the way to the bone.

For insurance, the single mother of two had just switched — as she'd been told to do in two letters from the state — to United Healthcare's AmeriChoice, a new program within the state's subsidized HUSKY plan.

From there, things went south.

Five months ago, Gov. M. Jodi Rell launched her Charter Oak Health Plan, designed to insure adults ages 19 to 64 who couldn't afford to insure themselves. But she linked it with the program of which Rebstock is a part, HUSKY, which is for low-income families with children. Health-care professionals who participated in HUSKY also had to take Charter Oak patients, but they proved reluctant to do that. Among other things, doctors wondered how they'd be reimbursed, and the linking proved to be a significant flaw in a noble idea. Health-care advocates and others pleaded that the programs be separated so the start-up program would not jeopardize the already established HUSKY.

When Rebstock's pain was nearly unbearable, the part-time bookkeeper started calling around for medical treatment. It was a Friday, and there were no dentists available or on call at the office where she already had an appointment for a root canal. Lacking a dentist, she started calling doctors, but receptionist after receptionist said they didn't accept her insurance. Meanwhile, her temperature rose to 102.

As the list of no's lengthened, Rebstock finally called her insurance company, where the nice receptionist apologized when she couldn't find an urgent-care center, hospital or doctor who would accept a new patient within 30 miles of Rebstock's Gales Ferry home.

Her only option was to go to the emergency room, but Rebstock would have had to take her kids, and she worried they'd catch a stomach virus that was making the rounds while she waited — most likely for hours — to be seen.

So Rebstock, a former veterinarian tech, went to the cabinet and found an antibiotic the family vet had prescribed for her dog. She took her dog's medicine until she was able to get a root canal — moved up from her original appointment in January — early the next week.

For a while, then, this is what the state- subsidized health-care system had wrought: frustration on the part of those who want to help sick people, and agony on the part of the sick.

Reacting to those concerns, earlier this month, Rell announced that the two plans would enroll medical professionals separately, and at a friendly meeting Tuesday between Michael P. Starkowski, commissioner of the Department of Social Services, and others, the commissioner clarified any confusion and announced that the programs could enroll doctors and hospitals separately. The hope, said David Dearborn, DSS spokesman, is that the move will help "accelerate" both programs.

Attorney General Richard Blumenthal, who attended the meeting, said, "I applaud this decision. At the same time, we have encouraged providers to participate in both programs. There is a need for both programs."

State Sen. Jonathan A. Harris, co-chairman of the legislature's human services committee, was also at the meeting. He said discussion should now turn to making Charter Oak successful, given that so many adults can't afford insurance and desperately need it. So far, just about 2,942 people are enrolled in Charter Oak, said Dearborn.

And discussion about HUSKY must continue, too. If the care that Rebstock received is any indication, there's still work to be done there, too. For her part, Rebstock remains philosophical. State insurance, she says, isn't going to be perfect, "but serviceable would be nice."