Northwest Territories Creates Online Benefits Calculator to Clarify Proposal
The Government of the Northwest Territories has created an online calculator and again pushed back a deadline for feedback after sustained criticism of proposals to change health benefits.
The territory is proposing changes to the benefits system that covers people who cannot access health coverage through work or other forms of government insurance.
Estimated that 2,200 NWT residents do not have access to benefits, the territory says its proposal “will ensure that all residents who need health benefits will be able to get them.”
But some residents say the territory has glossed over how its proposal, which eliminates the Specified Illness Program, would require some people with critical illnesses to pay out of pocket before benefits take effect.
The NWT Disabilities Council is the latest group to criticize the proposal.
Denise McKee, the council’s executive director, said the GNWT’s suggested new approach “would lead to built-in discrimination, is oppressive and does not reasonably understand…the disastrous consequences for people with disabilities.”
McKee said the proposal could force low-income families to pay deductibles and copayments out of pocket, exhausting third-party insurance before receiving territorial benefits.
The Disability Council is also concerned that the proposal appears to require people to take out liability insurance, which may be difficult or impossible to acquire under certain conditions. The council says preventing people from accessing government benefits if their pre-existing condition prevents them from buying third-party insurance would threaten a Charter violation.
“Even when insurance is approved, residents with pre-existing medical conditions may be subject to higher premiums and deficient coverage compared to residents without pre-existing conditions. This can have multiple negative consequences,” the council wrote.
Finally, the council said it was not “antithetical” to provide benefits to the point of providing benefits.
“This creates a real risk of poorer health outcomes, decreased labor force participation, increased social isolation and increased reliance on state-sponsored supports,” the council concluded.
More Comic Examples
On Thursday, the Department of Health and Human Services pushed back its deadline for feedback to November 23, having already moved the deadline once after earlier criticism.
This criticism related to the absence, in the documentation accompanying the proposal, of any examples highlighting the ways in which some people might have less access to benefits. All examples focused on residents whose access would increase.
“Additional examples, as well as a calculation tool, have been developed to help residents understand how the proposed changes will affect them,” the territory said in a news release.
“A virtual town hall will be held in mid-November to explain the proposed changes and answer questions from citizens. Details of the town hall event will be provided in the coming weeks.
More: GNWT Health Benefits Proposal Feedback Webpage
The GNWT website for the proposed changes now includes several additional comic book examples, which attempt to address several scenarios that critics of the proposal had raised.
The online calculator, meanwhile, asks residents for basic details related to income and status, then displays your annual deductible, family maximum, and copayment.
The deductible is the amount you must pay in drug costs before territory benefits kick in, in which case many people will be asked to pay a co-pay until they reach the family maximum, after which the benefit program covers all drug costs. for the rest of this year.
A single resident with an annual income of $40,000 has no deductible. They immediately receive benefits according to the calculator, paying a 30% copayment until they reach an annual expenditure of $600, at which point the benefit program takes over entirely.
A resident earning $70,000 has a deductible of $1,100, which means they pay that amount in drug costs before the co-pay process begins. The annual maximum for them is $2,000, in which case the territorial program pays in full for the remainder of the year.
A household with a net income of $200,000 has a deductible of $8,000, according to the calculator: if that’s you, you pay out of pocket up to $8,000 every year. After that, there’s no co-pay – when the $8,000 cap is reached, the territory’s benefits program pays next.
The territorial government adds a disclaimer that the calculator is only a tool used to estimate costs. The tool “represents the current proposed changes…and is not intended to address all unique situations,” the website states.