More than 700 families have dropped out of the state's RIte Care health insurance program since the state introduced small premiums earlier this year for people at the upper income levels of the plan. The information came to light this month in a report by the advocacy group Ocean State Action, which praised RIte Care's economic and health benefits.

The report by Community Catalyst of Boston warned that reduced participation in RIte Care could raise costs in other areas, since people whose health needs go unmet may turn to hospital emergency rooms for free care. As of May 1, a total of 709 families -- or 1598 people, including 1046 children -- have lost RIte Care coverage. Some former participants, however, may still have health-care coverage through a spouse.

The new premium affects about 10 percent of RIte Care's 43,214 families. Those earning between 150 and 250 percent of the federal poverty level ($22,530 to $37,550 for a family of three) are charged $43 to $58 a month. The drop of 709 families represents 17 percent of the 4140 families required to pay the premium. In some states, the use of premiums in similar programs has sparked the loss of half or more of the participants.

That such a high percentage of participants have remained in RIte Care "tells us something about the value families place on this benefit," says Jane A. Hayward, director of the state Department of Human Services, adding that DHS plans to study what has happened to families who have dropped out of the program.

But Marti Rosenberg of Ocean State Action worries that the premiums will tempt parents juggling rent, utility and food bills to skip coverage, gambling that they and their children will stay healthy. People who leave the program must wait four months before rejoining, except in the case of pregnant women and new babies.

Christopher F. Koller, chief executive officer of Neighborhood Health Plan of Rhode Island, the HMO that covers many RIte Care families, says families that have lost coverage will still seek care, and thus, taxpayers and health providers will foot the bill. "I think health-care should be made available to all, and I think people ought to contribute to their care," Koller says, adding that when some people are uninsured, "we all suffer the consequences. We all pay."

Issue Date: May 17 - 23, 2002