Matters relating to Health Insurance Exemption (HIE) income allowances

1240/5(2737)

WRITTEN QUESTIONS TO THE MINISTER FOR SOCIAL SECURITY BY DEPUTY G.P. SOUTHERN OF ST. HELIER

ANSWERS TO BE TABLED ON TUESDAY 14th FEBRUARY 2006

Questions

1. In answertomyquestionNo. 2715 on 31st January 2006, the Assistant Minister stated that the increase in any one benefit is unlikely to be the prime (or sole) cause' of loss ofHIEand that he would welcome examples of difficulties caused by the loss of HIE through the differential rates by whichbenefitsand thresholds were uprated.Would the Minister informmembers whether the departmenthas been madeaware recently of at least onecasewhere differential upratingisthe sole causeof loss of HIE?
2. Would the Minister informmembers whether any loss ofHIEhasoccurredat a levelofincomeof £9,000 per year being a figure below the relative low-income threshold revealed in the 2002 Income Distribution Survey?
3. Can the Minister confirm that,according to his ownfigures, the relative slippage' of rates over the past 5 years has been 5.5% (28% rise in benefits and 22.5% rise in HIEthreshold) and indicatewhether this has produced  significant  numbers of persons  who have been  placed over  HIE limits  without change in circumstances?
4. In the final paragraph of part (c) of his answer, the Assistant Minister stated that theRPI is the appropriate Index for uprating sinceHIE is part ofthe ultimate safety net'; can the Minister confirm whether the differential figures above indicate that HIEshouldnot be treated solely asincomesupport and whether medical needsshould be incorporated into any new system?
5. Would theMinisterprovidemembers with anonymised data relating toHIE/non-HIEattendancesbyGPs referred to in his previous answer?
6. N  otwithstanding thebroad outline givenintheIncome Support system and already agreed to by the States, would the Minister providemembers with details of any tapers' or othermechanismswhich will ameliorate the all or nothing' effect of currentincome ceilings and income bars and the income levels over which it is intended such tapers will operate?

Answer

1. The Department has been madeawareof only oneclaimwhere increased social insurance benefit incomehas been a factor. Theclaimant also hadincome from anothersourcewhichhad risen slightly.
2. To clarify, thereisno single low income threshold. The2002Income Distribution Survey (September 2003 report) actually quotes 60 possible relative lowincomethresholds for different household types. Toanswer the questionin full would require a disproportionate amountof staff time to auditeachclaim manually as relevant computerised data is not stored, in particular incomenotincluded in theassessment (some ofwhich is wholly disregarded).However, the Departmentis not aware of loss ofHIEatincomebelow £9,000 in recent months.
3. I would reiterate myanswerto the last question that the upratingof a benefit designed to replace income,and incomeallowances in a meansassessment, are notcomparable and henceitis appropriate to use different indices. Thewholepoint is to get people off means tested benefitsand help them becomeself sufficient. It would require significantresource to audit and review all claim details to ascertain individual reasons for exceeding the Income Criteria. Theweaknesses of the HIEsystem have been identified and the focus of the Department at this time ison developing and implementing the Income Support system that will supersede the HIEandother means tested schemes.

4. I would refer the Deputy to P.86/2005 asapprovedby the States. IncomeSupport will include four levelsof a "disability" component.People with illness or disability may have increased expenditure for a numberof reasons, including additional medical care.People who have an identified need for additional medicalcare (whether through illness or disability) will be able to make a claim for a disability component.Inaddition, the aim is to modify the HealthInsuranceschemeover time to give further help to people with chronic illnesses (irrespective ofincome)who require increased levels ofmedicalcare.
5. In 2005 a total of 43,623 doctors visits wererecordedbyHIE recipients and306,029bytheremainderofthe population.
6. The very nature of the system outlined and agreedby the States removes the all or nothing situation of income bars as subsidy is gradually withdrawnasincome rises. The Marginal DeductionRate gives incentive to increase income as a percentage and will be retained. P.86/2005 gave an example using a marginal deduction rate of90% and detailed calculations later this year will start from this basis. As the Deputy is aware, from his recentdiscussions with theDepartment,weareawaiting the outcomeof the Household Expenditure Survey so that themost up-to-date information is used.Theincome level will be calculated according to composition of the household and combinationof the componentsapplicable.Componentrates will besettowardstheend of 2006 and will ofcourse be subject to States approval.