N.D. forums to explore insurance choicesMost North Dakota insurance policies must carry an array of benefits, including coverage for cancer exams, back adjustments and surgery to correct a common jaw alignment problem. This week, the state Insurance Department is starting an experiment: Bring small groups of people together in North Dakota communities, give them a health insurance budget, and ask them if they’d prefer less expensive insurance plans that don’t include all the state-mandated benefits.
By: By Dale Wetzel, The Associated Press, The Jamestown Sun
BISMARCK — Most North Dakota insurance policies must carry an array of benefits, including coverage for cancer exams, back adjustments and surgery to correct a common jaw alignment problem.
This week, the state Insurance Department is starting an experiment: Bring small groups of people together in North Dakota communities, give them a health insurance budget, and ask them if they’d prefer less expensive insurance plans that don’t include all the state-mandated benefits.
The exercise lets participants build their own basic benefit packages from scratch. Information about their choices will be available to lawmakers, insurance companies and others interested in the health care priorities of North Dakotans.
“It was one of the best things I’ve done. It makes you sit back and really take a look at what is covered and what it costs,” said Drinda Olsen, a school health coordinator at the Department of Public Instruction.
Olsen was part of a group that tested the program in early July at the Insurance Department’s request. Its first community tryout begins Monday night at Dickinson State University. Other events are planned this month in Bismarck, Bottineau, Devils Lake, Fargo, Grand Forks, Harvey, Jamestown, Minot and Wahpeton.
The exercise is called CHAT, which stands for Choosing Healthplans All Together. It was developed by ethics and health policy professors at the University of Michigan and the National Institutes of Health.
In each of the 10 North Dakota forums, a group of six to 15 participants will be given 50 markers to “spend” on health insurance, with each asked to design his or her own benefit plan.
Participants will be quizzed about the health coverage and level of benefits they want. They’ll be asked about coverage for doctor and hospital visits, prescription drugs, eye exams and teeth cleanings.
They will have the option of paying less money in exchange for giving up their choice of doctors, or paying more to be able to pick the hospital where they will be treated. They may keep any unspent credits.
The exercise then will display a number of possible health problems, to show whether they would be covered by the newly crafted insurance plan — and ask participants if they want to rethink their original choices.
“Your heart muscle is weak. You can’t walk very far. Your doctor says that a heart transplant is the only option left,” one example says. Confronted with that possibility, participants who excluded organ transplant coverage would be given another chance to decide whether it was important enough to buy.
Once the participants in each group make their individual choices, they will be asked to agree on an insurance package to cover all of them. The entire exercise takes 2 to 2 1/2 hours.
Olsen said the group decision making helped to broaden her own perspectives, and gave her a fresh appreciation of the health insurance provided to full-time state employees.
“You get so focused sometimes on your own situation, and where you are, you really don’t sometimes see the needs of other people,” Olsen said. “You don’t stop to realize that many other people simply do not have what you have.”
Rebecca Ternes, the deputy North Dakota insurance commissioner, said the state exercises will include a variety of participants, including people who do not have health insurance, medical providers, and business people who offer coverage to their workers.
“It sure isn’t going to hurt to find out what people want, with limited resources,” Ternes said. “That’s what we’re trying to do, is start that conversation.”
In Minnesota, 29 groups were asked their own coverage preferences and questioned about whether they would give up insurance credits to extend coverage to uninsured adults and children.
All of them agreed to do so, with 22 groups opting to cover adults and children and seven electing to insure children only, according to a report on the exercise in the Journal of General Internal Medicine.
Early last year, the process was used to help evaluate a health benefit plan offered by Insure Montana, which provides taxpayer subsidies for small businesses that want to buy insurance coverage for their employees.
Jan VanRiper, a former Montana deputy commissioner of securities and insurance, said CHAT was also used with groups of Montana health insurance company employees, insurance sales people and doctors.
Low-income people generally preferred low deductibles for their medical coverage while higher-income participants wanted high deductibles and emphasized coverage for catastrophic, expensive medical problems, VanRiper said.
The North Dakota Legislature’s interim Industry, Business and Labor committee plans to go through the CHAT exercise itself next month, said the panel’s chairman, Rep. George Keiser, R-Bismarck.
Ternes said data from this month’s meetings will be presented to the interim committee and the Legislature itself.
“We hope the companies are interested in it, so that we can tell health insurance companies, for the North Dakotans we’ve sampled — and the conversations that we had — this is what we found to be most important in a basic coverage plan,” she said.