Speakers Express Division on Bill To Mandate Health-Care Coverage

By Nikita Stewart
Washington Post Staff Writer
Saturday, May 3, 2008

District residents with chronic illnesses, representatives of HMOs and convenience store owners testified yesterday at a D.C. Council hearing on far-reaching legislation that would mandate health-care coverage for all residents.

The city would subsidize the program, Healthy DC, by doubling the tax on a pack of cigarettes to $2, creating a 2 percent premium tax on HMOs and increasing the tax on commercial health-care premiums by 0.3 percent.

Funding requests for the program could be attached to the 2009 fiscal budget when the council votes on the legislation May 13. If it is passed and enacted, every resident in the city would be required to have insurance or face a $250 fine.

The subsidized program would cover residents who do not qualify for Medicare, Medicaid or the DC Healthcare Alliance, a city insurance program for low-income residents who are ineligible for other public assistance. About 45,000 residents could be covered by Healthy DC, which would cost an estimated $50 million. The city would provide a subsidy of $21 million.

To enroll in the plan, the uninsured would pay $20 to $100 in monthly premiums, depending on their incomes.

Yesterday, health-care advocates and city officials raised concerns about allowing the District to enter into a contract without a bidding process. According to the legislation, the city would enter into an agreement with CareFirst BlueCross BlueShield to expedite the program so that it could start in July 2009.

CareFirst's "having a monopoly could pose problems," said Heather McCabe, senior health policy officer in the Office of the Chief Financial Officer.

Convenience store owners fretted about another issue. Smokers could take their business elsewhere if they have to pay $1 more per pack, said Mark Chiohankitmun, president of the Franchise Owners Association, an organization for 7-Eleven stores. "We believe it would drive cigarette sales and the related items . . . to Maryland and Virginia," he said.

Rick Hussein, a 7-Eleven franchisee, said cigarette sales make up 40 percent of revenue for some convenience stores.

The testimony drew passionate responses from Chairman Vincent C. Gray (D) and council member David A. Catania (I-At Large), chairman of the Committee on Health.

Catania cited data showing that each pack of cigarettes sold in the District costs the city $10.28 in smoking-related health expenses. Gray said he had heard arguments about dwindling business when the council approved a ban on smoking in restaurants, but he said he has not seen a decline. "I find it hard to make an argument around smoking. Smoking kills people," he said.

People testifying about their bouts with cancer and other diseases praised the legislation.

Resident Patricia Jaby, 56, said she has lupus and has had difficulty finding an insurance company to accept her "preexisting condition."

She said she earns too much money to qualify for the DC Healthcare Alliance, which caps individual earnings at $21,000.

Jaby, a U.S. Postal Service worker, said she has found one way to become eligible: "I have to be off work for two months each year to qualify."

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