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Bredesen says new CoverTN health insurance program is off to a good start

March 9th, 2007 9:18 pm by Rick Wagner

Bredesen says new CoverTN health insurance program is off to a good start



Gov. Bredesen presents Nikki Glover, manager of Shadrack Water Sports, with a CoverTN card during a press conference at Holston Valley Medical Center. Photo by David Grace.


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KINGSPORT - More than 600 Northeast Tennessee small businesses have applied for CoverTN health insurance, and one of the two major Tri-Cities hospital systems is accepting it.


Gov. Phil Bredesen on Friday said those two things show that the state program, which provides health insurance to eligible uninsured employees of small businesses and the self-employed, is off to a good start.


"We've gone from idea to action," Bredesen said during a news conference at Holston Valley Medical Center, part of the Wellmont Health System that is participating in CoverTN.


The more than 4,500 small business applicants across the state before the program has been promoted and advertised is "beyond my wildest dreams," Bredesen said.


"It is a solid step forward in helping Tennesseans who have been without health care too long," he said.


Bredesen kicked off the program he spearheaded by presenting a CoverTN health insurance card to Mikki Glover, a manager at Shadrack Water Sports and RV, a business owned by her father. It has stores in Bristol, Tenn., and Knoxville and a campground in Bristol.


"I can't think of a more appropriate place to kick it off than Holston Valley," the governor told about 100 people.


Holston Valley Medical Center, along with Bristol Regional Medical Center, are the two largest hospitals in the Sullivan County-based Wellmont Health System.


Wellmont and its chief competitor, Johnson City-based Mountain States Health Alliance, both initially declined to participate in CoverTN. But after talks between Wellmont President and Chief Executive Officer Dr. Richard Salluzzo and David Goetz, Tennessee commissioner of finance and administration, Wellmont decided to participate.


"It was a case of Dave kind of sat down with the hospital and really answered the questions they had," Bredesen told reporters after the news conference. "I'm not aware of any special deals or things like that."


Salluzzo said Wellmont officials see program participation as part of the system's mission.


"We don't know if we deserve special accolades for doing what we do every day," Salluzzo said, adding that Wellmont in the past month had $1 million in expenses for a single patient without insurance coverage but provided the same care to that patient as insured ones. "We believe health care is a birthright."


Bredesen said MSHA is "always welcome," but he believes Wellmont will "get considerable business out of this."


"This was the most difficult part of the state to put a hospital network together," Bredesen said, adding that MSHA's opting out was "a business decision" with which he doesn't agree.


MSHA Vice President of Communications Ed Herbert on Friday said MSHA's position on the issue has not changed.


"Mountain States Health Alliance is our region's safety net provider for the uninsured and is the largest provider of TennCare and Medicaid services in our part of the state," Herbert said in a written statement. " Although MSHA is not participating in CoverTN at this time, we applaud the governor's efforts at attempting to deal with the problem of the state's uninsured population as demonstrated through our support of the other four components of the Governor's Cover Tennessee program - CoverKids, AccessTN, CoverRX and Project Diabetes/Coordinated School Health while continuing to evaluate our participation in the fifth component of the Cover Tennessee program - CoverTN."


A sticking point for MSHA is the $10,000 to $15,000 annual cap on hospital coverage, depending on the plan chosen. But Bredesen said the program is designed to get people in the door for preventative care, access to doctors and pharmaceuticals, not for a once- or twice-in-a-lifetime catastrophic illness.


"In any case, you're going to get $10,000 or $15,000 more than you did before," he told reporters.


The umbrella Cover Tennessee program, which includes CoverTN, is estimated to cost about $486 million over the next three years. That includes $295 million in state dollars but no federal funding.


Bredesen said the program is affordable, with individuals to pay an average monthly premium of $50, with another $50 paid by the employer and another $50 paid by the state. It also is portable when employees change jobs. Co-pays are $25 for a doctor's office visit and $10 for generic prescription drugs.


Premiums range from $34 for a young, healthy non-tobacco user to $99 a month for an older, obese tobacco user.


Business eligibility requirements include being located in Tennessee, having 25 or fewer employees, 50 percent of the work force making $41,000 a year or less, and the business offering no employee-sponsored insurance for six months or, if offered, the business has not paid 50 percent of the premiums.


Bredesen said the program drew bipartisan support and is relatively simple.


Blue Cross Blue Shield of Tennessee won the bid to administer the program. Sullivan County native Ron Harr, vice president of Blue Cross in Tennessee, said the program fits in with the Blue Cross mission to bring health care access to all Tennesseans. But he said the 80 hospitals and 10,000 participating physicians will "make it work."


For more information go to www.covertn.gov or call (866) COVERTN.


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