Paying to be Uninsured

YI just got back from the press conference held by Assembly Republicans to unveil their health proposal, where they showed how their plans would help small businesses and young people.

The young person featured was a nice 22-year-old named Suzanne Hernandez who is enrolled in Blue Cross’ “Part-Time Daredevil” Tonik plan, which has a $3,000 deductible.

Miss Hernandez doesn’t get coverage through her employer — Lucille’s Smokehouse BBQ in Rocklin. The restaurant industry, she explained, often does not offer benefits and most employees don’t work full-time, which means they wouldn’t qualify for benefits anyway.

(First off, the solution here would be to require businesses to provide coverage to both full- and part-time workers. Then, Miss Hernandez wouldn’t be on her own.)

The Tonik plan, she said, gives her 4 doctors visits a year for a $30 co-pay. That’s what she needs ….for now.

As a young woman, though, she might need maternity, I said. What would happen if she got pregnant?

Her broker stepped in and said Blue Cross actually allows Tonik enrollees to roll into a higher deductible plan — $5,000 a year — which includes maternity. And childbirth, the broker said, costs a lot more than $5,000.

But $5,000 on a part-time job at a restaurant still seems kind of expensive, I said.

Well, said the broker, there’s social programs for that, called AIM — Access for Infants and Mothers.

That’s right — a person that doesn’t have adequate insurance through Blue Cross should enroll in Access for Infants and Mothers — a state program for low-income women who have deductibles that are too high, the broker said.

The last time I looked, Access for Infants and Mothers was a government program — the kind that Assembly Republicans said today they didn’t really think would work.

I wonder what they would think if they knew that part of this Blue Cross business model — as advised by the broker — relied on social programs to provide the rest of the health coverage that the insurance company itself does not provide.

Health Access California promotes quality, affordable health care for all Californians.

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