City Councilman John Cranley has announced an ambitious health-care plan for the working poor.
The plan, which he won’t formally propose until after the Nov. 6 election, would use city funding to help provide health care for workers at a cheaper rate for both employees and business owners.
Cranley’s proposal — called “CincyCare” — would have premiums of approximately $1,500 per year per person, split into thirds among the city, an employer and an employee. That would cost approximately $10 per week for each employee, matched by the same amount for employers and the city.
CincyCare would provide unlimited access to Cincinnati’s six health care centers and insurance for an additional $25,000 of health care.
“The studies show that $25,000 a year covers 98 percent of all health care claims,” Cranley says. “Basically the model is that you have this huge gap of people between the ages 18-65 who are working and they don’t have high-quality — or any — care. And what we’re finding is that, by focusing on primary care and preventive care, we can focus on a lot of problems before they get serious, help a lot more people and actually deliver health care to people in a more effective way than what is currently out there.”
The six health centers would be available at an 80 percent discount over the market rate under the plan, according to a packet prepared by Cranley’s office. Additionally, participating employers would receive a $500 tax credit per subscription. Those credits must, however, be used “exclusively to contribute to the annual premium.”
Taking $500 from the annual premium leaves roughly $1,000 to be split between employer and employee.
“Assuming a 50-50 split means that CincyCare is available to employers and employees at roughly $10 per week or $40 per month,” Cranley says.
Cranley says the plan could give the city a competitive advantage in economic development over suburban jurisdictions.
“Right now (the city provides) health care to indigent people, and often times don’t expect to get reimbursed,” he says. “So that care is there, regardless of whether we charge people for it. As a result, it occurred to me that we ought to be able to leverage the same capacity, charge something — but not nearly as much as the private market would charge — and then give businesses an incentive to locate in the city of Cincinnati because they would get this discount on health care for their workers.”
That would also provide the health department access to a new source of revenue.
The lack of such a program has been costing those who do pay for insurance, because the cost of the unpaid care gets spread to others, according to Assistant Health Commissioner Hirsch Cohen.
“If you don’t provide health care as a community, the people who need it can end up in the emergency room at the cost of eight times what a primary care visit would cost,” he says. “If you give people a primary care home, they won’t end up going to the emergency room.”
While it’s unclear what kind of opposition the health plan will meet, last year’s budget standoff nearly ended in deep cuts for the health department.
Cranley says he’ll only ask council if it’s willing to commit to trying to create a program like CincyCare, then begin to find the savings elsewhere in the budget to provide the city’s share.
“We will find the cuts before we ask for final approval,” Cranley says.
Though the initiative has used at least four other programs from around the country for guidance, one expert said this version is distinct.
“There are cities that have proposals, like Muskegon, Mich., based on similar formula or structure targeting low-wage workers,” says Judith Warren, senior officer of Community Primary Care Health Foundation. “In Hamilton, Health Share Select provides a benefit package for low wage workers but does not have contribution from city government.”
Cranley also distinguished CincyCare from other plans.
“The difference between San Francisco and Cincinnati’s plans is that San Francisco is adding mandatory tax for businesses for doing this. (CincyCare) does not.” ©