Small Group Health Insurance Reform in Rhode Island: Promises and Pitfalls of the HEALTHpact Plan

Authors

  • Edward Alan Miller,

    1. Department of Gerontology, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125
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    • Address correspondence to Edward Alan Miller, Ph.D., M.P.A., Associate Professor, Department of Gerontology, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125; e-mail: edward.miller@umb.edu. Edward Alan Miller, Ph.D., M.P.A., Associate Professor, is with the Department of Gerontology, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, Boston, MA. Amal Trivedi, M.D., Assistant Professor, Sylvia Kuo, Ph.D., Assistant Professor (Research), and Vincent Mor, Ph.D., Professor and Chair, are with the Department of Community Health, Brown University, Providence, RI.

  • Amal Trivedi,

    1. Department of Community Health, Brown University, Providence, RI
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  • Sylvia Kuo,

    1. Department of Community Health, Brown University, Providence, RI
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  • Vincent Mor

    1. Department of Community Health, Brown University, Providence, RI
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Abstract

Objective. This study analyzes what design elements inhibited enrollment in HEALTHpact.

Study Setting. HEALTHpact is a high deductible plan with a premium capped at 10 percent of the average Rhode Island wage. Deductibles are reduced if enrollees meet wellness criteria.

Study Design. Qualitative case study.

Data Collection. Archival documents and 23 interviews.

Principal Findings. Inclusion of a subsidy would have led to lower premiums and more generous coverage. Although priced lower than other plans, HEALTHpact still did not offer good value for most firms. Wellness incentives also were too complex.

Conclusions. Subsidies for purchase of insurance coverage are critical to national reform of the small group market. Designers also will need to carefully balance program complexity with innovation in encouraging wellness and product appeal.

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