Exchange staff back off eroding essential health benefits

At yesterday’s CT Health Insurance Exchange meeting we learned about an attempt by Exchange staff and the Insurance Dept. to reduce the Essential Health Benefit Package that had been agreed to earlier this year in a contentious but inclusive and public process. Like the last process that rejected active purchasing, this process happened in evening conference calls not open to the public in a very short time frame. This time, however, providers and advocates on the committees voted down the benefit package erosion (active purchasing was not part of the reconsideration) and the staff finally agreed to pull the proposal from the Board committee agenda yesterday. However at the meeting, staff stated that they plan to lobby the fed.s to let them re-consider, and lower, the agreed-upon essential benefit package. The issue is CT mandates for coverage in state law – whether they cost or save money in premiums and how much. A public commenter noted that affordability is very important, but eroding mandates may not work to keep costs down. Active purchasing is proven to reduce costs, but the Board and staff have rejected that proven tool and have indicated no interest in re-visiting that decision. Other news included a strong theme of affordability in the Healthy Chat public events. Staff noted that many people were new faces to health care, not traditional activists. They also noted that people had “done their homework” and were very sophisticated in their understanding of active purchasing and its potential for affordability. The staff is still working on the details of the health plan benefit standards and benefit design, how plans will be rated for innovation and plans for quality monitoring. Advocates will be watching this process carefully for further standards that erode consumer protections, if there is any transparency or opportunities for meaningful public input.

HHS approves CT insurance exchange plan

Along with six other states, CT’s health insurance exchange received approval yesterday from the federal agency providing funding. CT was among the first six states to apply to HHS for approval – 14 states have applied to date. No state’s application has been denied. CT’s exchange has been criticized for their plan to accept any willing plan and refusing to negotiate with insurers to control costs and reduce consumer premiums. CT’s exchange also voted not to conduct a secret shopper survey to monitor whether people who purchase their insurance plans can find a provider. The exchange has also been criticized for having no independent consumer Board members, having Board members with close ties to the insurance industry and for members with insurance company investments.

Outreach recommendations for reform

Small grants, engaging an army of trusted community messengers, ubiquitous marketing, and robust monitoring will be critical to enrolling the estimated 130,000 newly eligible CT Medicaid members in January 2014, according to a report by the CT Health Policy Project. Best opportunities for outreach include small businesses, providers, current HUSKY members, faith-based communities, connecting with employers and other state programs, targeting life transitions, improving application and enrollment processes, and thanking outreach partners. It will require strong, concerted efforts to overcome the program’s stigma and other barriers to enrollment. The report draws on the experience of community organizers, consumer advocates who worked on HUSKY outreach, providers that care for CT’s uninsured patients, and lessons from other states. While aimed at Medicaid, many of the report’s findings also apply to the new CT Health Insurance Exchange. Report

Exchange Board and staff water down already watered-down affordability and access provisions In a surprise to advisory committee co-chairs, CT Health Insurance Exchange staff submitted four alternative policy proposals at today’s Board meeting – they were adopted virtually intact by the Board. The staff alternatives were contrary to the recommendations adopted Tuesday by the Consumer and Qualified Health Plan Advisory Committees, with Exchange staff at every meeting. One staff change increased the number of options insurers can offer (in response to insurance industry comments); research shows that consumers prefer and make better choices with a limited number of well-vetted options. Another eliminated a secret shopper survey to ensure that the plan’s provider panels are accurate; in a Mercer study of HUSKY plans, shoppers were only able to get appointments with one in four providers on those HMO panels. Staff stated that accountability in secret shopper surveys seem “too adversarial” with insurers. Another proposal reduced the number of essential community providers that plans have to include in their networks, such as community health centers. The last one eliminated even the guidance that the Exchange will develop a plan of some undefined type to eventually, someday move along a continuum toward an active purchasing model. Active purchasing now saves MA exchange consumers millions in premiums by fostering competition and negotiating rates with insurers.

Staff reviewed comments to the draft health plan solicitation. Ten of the 22 comments mentioned were from insurers – half were accepted in the staff proposals, two were not, and three others were not relevant. Five comments came from NCQA, two from unknown sources, four from this consumer advocate (none were reflected in proposals) and one from a provider (was reflected in joint committee proposal).

The Exchange staff also announced they have hired Pappas Macdonnell, a Westport marketing firm with experience in selling corporate insurance and financial products. When asked if they have any experience in marketing to low-income, uninsured populations, one representative noted that he has worked on Democratic political campaigns.

In other news, they have settled on a new name for the Exchange – Access Health. They also have submitted an application for $2.6 million in federal funding for application assisters. They expect to award about 300 grants of about $6,000 each to community organizations to publicize the exchange, help people figure out what assistance they are eligible for, and help them enroll. They have hired three new Exchange staff this month.

The official vote tally for today’s vote to kill active purchasing

From Exchange staff: Below lists the results of the votes cast by the Consumer Experience and Outreach and Health Plans Benefits and Qualifications Exchange Advisory Committees with concern to the certification of Qualified Health Plans within the Exchange.-- Note -- a vote to approve is against active purchasing -- Results:
Twenty (20) – Approve Two (2) – Reject Approve
-- Sheldon Toubman Vicki Veltri
Gerard O’Sullivan Anne Melissa Dowling Deb Polun
Marcia Petrillo
Steve Frayne
J. Erlingheuser
Mark Espinosa
Gloria Powell Margherita Giuliano Tanya Barrett
Bonnie Roswig
Mary Fox
Alta Lash
Arlene Murphy
Sarah Frankel
Cee Cee Woods
Dr. Robert McLean Dr. Robert Scalettar Reject
-- Kevin Galvin Deirdre Hardrick

Joint exchange committees voting down active purchasing, cost control

While the votes are reportedly still coming in, it appears that the Consumer and QHP Insurance Exchange committees have voted against active purchasing. With active purchasing, other state exchanges are using the power of numbers, as large employers do, to negotiate better premiums, lower costs and better coverage for their members. MA has saved millions for consumers in their state with active purchasing. While the committees’ language includes a symbolic nod to possible future negotiation, it is far weaker than current state law. Reportedly, through a procedural maneuver, Exchange staff and committee co-chairs agreed to link all the proposals in one vote. Providers on the committees were picked off by adding back requirements that their organizations be included in network standards. Reportedly consumers lost votes we would have had if active purchasing had had a fair vote. All meetings this week and negotiations over language were conducted in secret. A critical negotiation session happened by conference call, but the public was not allowed to listen in. (The public was told to come to the LOB, from 6 to 7pm Monday to hear the call. However the building closes at 5:30.) This secrecy would not be allowed if the Exchange was part of state government – there are laws about that. But as a quasi-public entity, they can make their own rules. It is ironic as 50% of the Board members are public officials (71% if you count spouses and retirees), and all their millions in funding come from taxpayers. Exchange staff also incorrectly argued that they had to have this issue decided in time to release the health plan solicitation next month. However, state RFPs rarely release specifics on how they will score bids with the RFP release. Why would you? Now the HMOs know that as they prepare their premium bids, that the sky is the limit. We will post the vote tally as soon as we get it.

Just 6 days to comment on exchange health plan solicitation

Stakeholders had only six days to comment on the 40 page health plan solicitation from the CT Health Insurance Exchange – and it’s already over. Stakeholders in CA and MD had months to comment, with multiple drafts, meetings and opportunities to craft better proposals. The CT Health Policy Project’s initial comments centered on active purchasing, network adequacy, and the proposed “iterative process”. MA’s Connector has used active purchasing to save consumers millions in premiums – CT should do the same. When consumers are required to purchase coverage in the exchange, they must be able to get an appointment with a provider. HUSKY secret shoppers were only able to get appointments with 1 in 4 providers on the health plan lists. Using the standards from HUSKY contracts, thoroughly vetted in CT, and intensely monitoring compliance is key. The exchange’s proposal to initially implement a weak exchange and implement some standards later will sound eerily familiar to CT advocates – with a very poor history. Other comments include better cost sharing structures, standardize rating options so differences are meaningful, wellness programs that aren’t a screen for cherry-picking, constructive connections to the Medicaid program, accreditation standards, quality improvement plans (at least have one), and CID rate reviews as a floor. Perhaps the most troubling thing about the proposal is how much is taken on faith in attestations from insurers. Will anyone be monitoring to see if the promises are real?

Exchange advisory committees reject “any-willing insurer”

Today in a joint meeting of the Health Plan Benefits/Qualifications and Consumer Experience/Outreach committees of the CT Health Insurance Exchange voted against the staff recommendation “that the Exchange not deny any carrier QHP certification on the basis of its approved rates”. The only votes for the staff’s any willing insurer proposal were from Aetna and CT Insurance Dept. representatives. The committees asked staff to come back with a new proposal that includes rate negotiation.

CT Insurance Exchange holding public events

In response to concerns about the lack of public input, CT’s Health Insurance Exchange will be holding seven “Healthy Chat” events in the next month. Similar to Consumer Conversations last month but sponsored by the exchange this time, they will be reporting on their activities but will also be taking questions. We will be asking why they aren’t willing to negotiate with insurers to keep premiums affordable. The events will all be 5:30 to 7:00pm with registration at 5:00. The events will be in Hartford on November 27th, Waterbury on November 29th, New London on December 4th, New Haven on December 6th, New Britain on December 11th, Stamford on December 13th, ending with Bridgeport on December18th. For more details, click here.

Where Are The Consumers in the Consumer Committee??

I attended this week’s CT Health Insurance Consumer Experience and Outreach Committee meeting to give the Committee an update on the success of the previous week’s Advocate’s “Conversation with Kevin Counihan” event sponsored by Small Business For A Healthy Connecticut and CT Health Policy Project. My point was to emphasize the importance of consumer involvement at the upcoming combined meetings of the Consumer and Qualified Health Plan Committees. My attention was immediately drawn to all the empty chairs at the Committee table. Of the fifteen Committee members listed on the Exchange web site (a list that is not accurate), seven were present and one was participating by phone. Of the eight Committee Members attending, three were Exchange Board Members. With consumer voices being so few in the Exchange structure the Committee absences are particularly troubling. WHERE IS THE CONUMER’S VOICE IN THIS?
Why were the seven Committee members not there?
Why was the Co-chair not there?
Where were the consumers to access their right to address the Committee? The audience was primarily made up of insurance industry representatives and lobbyists. I commented that there were probably more folks in the room with (.Gov) email addresses than there should have been or needed to be for a meeting of consumers. With nearly half of the Committee members missing, what are the Committee members that were present going to do to impress the importance of attendance to the members who were missing? Might it make sense to have Committee meeting times after normal working hours to better accommodate the consumer audience? Might the Committee adopt the practice of having Public Comment at both beginning and end of each meeting again to better accommodate the consumer audience? What are the Committee’s plans to have consumer attendance at the upcoming combined Committee meeting? I’m not sure how we can expect the general public to take the implementation of Health Care Reform seriously when the people charged with representing us do not show up to meetings. Kevin Galvin

Why CT’s health insurance exchange needs to negotiate

CT’s health insurance exchange is not planning to negotiate with insurers to improve value and control costs for consumers. As of January 2014, consumers will be mandated to secure coverage. Consumers eligible for affordability assistance must purchase in the still developing exchange to get the subsidies. Massachusetts’s exchange (the Connector) negotiates, termed active purchasing, with insurers saving consumers $16 to $20 million annually. In contrast, Utah’s exchange does not negotiate with insurers but includes any qualified insurer, as the CT exchange is planning, and premiums are HIGHER inside the exchange than in the outside market. There is some disagreement about whether the Board and the Qualified Health Plan Committee have already made the decision. No public comment was solicited on the issue and the decision memo was posted a day after the QHP committee meeting. For more on the issue, go our Policymaker Brief.

CT health reform progress up to 16.7%

CT inched up only 0.3% in progress toward health reform last month. We have completed 16.7% of the tasks needed to be ready for January 1, 2014 when individuals will be legally required to secure health coverage. Highlights remain Medicaid and patient-centered medical homes. Unfortunately, problem areas continue to be the insurance exchange and insurance review. Last month, CT health care thoughtleaders gave CT a C+ grade for reform progress. For more, visit the CT Health Reform Dashboard at www.cthealthreform.org.

Consumers raise concerns with CT insurance exchange

Consumers and small businesses had a rare opportunity to share their concerns with CT’s health insurance exchange Friday. A standing room only crowd met with the exchange’s CEO, Kevin Counihan at a restaurant in Glastonbury. Christie Hager, HHS Regional Director, also attended. Comments focused on the lack of consumer and small business input to the exchange, inappropriate influence of insurers, and the exchange staff’s decision not to negotiate with insurers to get the best value for customers. Through negotiation, MA’s exchange has been able to keep the rate of premium increases to half what it is outside their exchange. However prices in Utah’s exchange, which does not negotiate with insurers as CT’s exchange is planning, are actually higher than prices outside the exchange. CT’s exchange is being set up by the state, with millions in federal grants, to help consumers get decent, affordable coverage and is expected to purchase on behalf of one in ten state residents. As of Jan. 1, 2014, everyone in CT will be required to have coverage. Residents who qualify for federal affordability subsidies will have to buy their insurance through the exchange. Check back at the CT Health Policy Project’s site soon for a brief on the benefits for CT consumers, promoting value and affordability, through negotiation on CT’s exchange.

CT exchange staff won’t negotiate with insurers on behalf of consumers or small businesses

Staff of the CT Health Insurance Exchange have “opted to utilize an ‘any qualified plan’ approach” for determining which plans can be offered in the exchange. Proposed qualifications are minimal and generally only what is required by the Affordable Care Act. This decision is counter to the CT exchange’s own research. According to the market consultants, “One of the most attractive aspects of the Exchange is that the big insurance companies compete for their business. The feature evoked references to Lending Tree’s slogan ‘When banks compete you win.’” Utah’s health insurance exchange has pursued an “any qualified plan” approach, similar to CT’s staff proposal, and has attracted little enrollment with no evidence of cost control. Massachusetts’s Connector, on the other hand, operates with an active purchasing approach – negotiating with insurers to get the best price and quality for consumers. Annual premium increases for plans in Massachusetts’s exchange have been half the increase of plans outside the exchange. Starting in 2014, every CT resident will be required to secure health coverage. Over 150,000 state residents will have to buy it in the exchange to get federal affordability subsidies. According to the staff memo, the decision not to negotiate on behalf of consumers has been made and they are only taking comment on how to implement that policy. The memo was delivered Monday to the Qualified Health Plan Committee that no longer includes a consumer representative due to the unfortunate loss of Jennifer Jaff.

CT still earns a C+ on reform

Once again, CT health care thoughtleaders give our state a C+ on health reform. From the beginning of the CT Health Thoughtleaders Survey in February, CT has varied between C and C+. CT has always received a B for effort. In good news, grades for the CT Health Insurance Exchange improved since June with fewer D’s and some A’s in this survey. Unfortunately, grades for Engaging Consumers in Policymaking and Data-based Policymaking have fallen. The former was the most common recommendation from thoughtleaders to improve progress toward reform. The overwhelming response was to engage consumers in policymaking – increase consumer voices, greater public engagement in the process, and engage advocates. Other suggestions included smarter policymaking (data, best practices), improve communications and transparency, convene stakeholders to build trust, and guard against conflicting financial and special interests. New questions in this survey found that almost all thoughtleaders are somewhat or very engaged in the process of reform, however all but four cite barriers to engagement. Understanding how critical stakeholder engagement will be to success, policymakers should work to improve effective, meaningful access to the process. A disturbing number of respondents have not been asked, or have tried but found few ways to participate. The Thoughtleader Survey is part of the CT Health Policy Project’s Health Reform Dashboard project at www.cthealthreform.org.

Exchange Board approves Essential Health Benefits standard – false choice between benefits and cost

Yesterday the CT Health Insurance Exchange Board approved CT’s version of the Essential Health Benefit (EHB) package under the Affordable Care Act (ACA). As of January 1, 2014 individual and small group plans will have to cover at least the EHB services. The ACA required that the EHB include at least ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse care, prescriptions, rehab and habilitation services, lab services, preventive and wellness care including chronic disease management, and pediatric care including vision and dental care. States have several plan EHB options including large commercial plans, federal and state employee plans. After long, contentious deliberations, two exchange committees of experts and stakeholders agreed on a moderate, compromise choice based on ConnectiCare’s HMO plan that includes all state mandates. The committees recommended that compromise to the Exchange Board. While the Board eventually approved the committees’ recommendation, there was a great deal of discussion about reducing the “richness” of the plan in the interest of “affordability”. Board members noted that the recommended plan is “richer” than what is offered now in CT. They failed to note that one of the main points of reform was to improve the “value” of health insurance so it truly covers what people need. If what is available now was sufficient, we wouldn’t have needed reform. The Board wants the legislature to “revisit” legislatively mandated benefits next year, eliciting groans from lobbyist and advocate observers in the room. Unfortunately there was no meaningful discussion about the potential for ongoing payment and delivery innovations successful in many other states, to provide flexibility that improve quality, access, patient satisfaction while controlling costs. The Board includes no independent consumer advocates and several insurance industry representatives. Consequently the Board is locked in the narrow false choice between mandated benefits and affordable premiums. That very old, very simplistic dialogue only spirals downward into worse care and upward into skyrocketing costs. The Board is missing a massive opportunity to learn from innovators and truly reform CT’s health care landscape.

Join us for Consumer Conversations: the CT Health Insurance Exchange

January 1, 2014 every CT resident will be required to secure health coverage. The CT Health Insurance Exchange is being developed under the Affordable Care Act to be a fair, user-friendly marketplace for consumers and small businesses to buy decent coverage, hopefully at an affordable price. The Exchange has not heard consumer voices, does not include any independent consumer Board members, and is dominated by insurance interests. Small Business for Healthy CT and the CT Health Policy Project have invited Kevin Counihan, CEO of the exchange, to meet with consumers and small businesses to learn what consumers need and how to make the exchange a success. We will also be joined by Christine Hager, Regional Director of HHS, the federal agency funding the exchange. The meeting will be October 26th from 8:30m to 11am at the Pond House Grille in Glastonbury. To register, click here.

CT Health Insurance Exchange and other briefs posted

The CT Health Policy Project’s 2012 candidate briefing book on CT’s health is posted – including a brief on the CT Health Insurance Exchange. In addition, this year’s book includes briefs on twelve other timely issues including health care cost drivers, Accountable Care Organizations, and CT & national health reform. The briefing book is part of www.cthealthbook.org – our resource library on health care issues and solutions facing CT.

Insurance Company Shenanigans – Part 2

If you live in CT and are insured through Golden Rule, now also known as United Healthcare’s United HealthOne; you should read the State of Connecticut’s Insurance Department notice # 509542, dated 8/17/2012. They filed a rate increase of 9.9% which the State of Connecticut cannot deny; since they filed it saying they will reimburse policy owners if they don’t spend 80 cents of every dollar on medical expenses. Let me interpret for you; according to the State of Connecticut, they are charging 3.3% more than they should be charging. Basically, on average, they are charging and collecting $380 more per year next year than this year; or by the State’s estimate $125 more per year than they should be charging you! Doesn’t sound like much, but consider this: you are financing the operations of a company that paid its CEO over $50 million in salary and benefits just a couple of years ago! Is this fair? Consider that $125 is the average, and that people with family plans are overpaying by far more than $125 per year to finance this $100 billion dollar corporation. Tony Pinto

Insurance Company Shenanigans – Part 1

In case you’re wondering why you don’t hear insurance companies complaining about Obamacare; it’s because they are big winners and don’t want to rock the boat. Insurance companies are “limited” to either paying out 80% of every dollar collected in the Individual and Small Group business market or 85% of every dollar collected in the Large Group business market. What this means is that they can keep 20% or 15% of every dollar respectively for themselves to cover their operational costs and create profits for them. Think about that… In the Individual and Small Group markets, they can keep 20% for themselves to pay their expenses and fill their pockets. Doesn’t seem like a big number; but, this means that the more expensive in dollars the health plan is; the more they make in profit. For example; if you buy a health plan that costs $400 per month with high co-payments; they can make $80 per month at-most at 20%. However; if you buy a health plan that costs $600 per month with lower co-payments; they can make $120 per month at 20%. Interesting, isn’t it… The more a health plan costs; the more profitable it can be for the insurance company. Tony Pinto

When choosing a plan in the exchange, actuarial value just a starting place

A new real-world analysis by the Commonwealth Fund demonstrates devil in the details of the bronze/silver/gold/platinum health plan actuarial value levels designed to guide consumers and small businesses choosing plans in the new insurance exchanges. The metal categories were designed to organize and make sense of confusing choices and combat deceptive insurance industry marketing practices. The analysis describes the very different costs and coverage available to individuals under plans from the same metal category. In some cases a “better” plan based on actuarial value can end up costing consumers more depending on their costs during the year. Unfortunately it is very difficult for most consumers to predict their future health costs – isn’t that why we have insurance in the first place? The study concludes, “actuarial value is a useful starting point for selecting a plan, but it does not pinpoint which plan will produce the best overall value for a particular person.” So much for making things simple. As of January 2014, consumers will be required to secure health coverage under federal law. Individuals eligible for premium subsidies must purchase coverage in the new state insurance exchanges. Leadership of CT’s Health Insurance Exchange, now developing, has been criticized as dominated by insurers and lacking independent consumer representation.

CT health reform progress up to 15.2%

CT made impressive progress toward health reform in August. We moved from 13.7% of the way to 15.2% this month. Highlights include negotiation of a compromise Essential Health Benefit Package and CMS grant funding to the insurance exchange. The grant is very exciting – the state plans to use most of the funding for a new, comprehensive IT system. If we do this right, this could solve a lot of our systemic problems. Unfortunately we fell behind in limiting monopoly providers by approving the Yale-New Haven – St. Raphael’s merger raising serious concerns about access to care for New Haven area un and underinsured consumers, and about costs for all of us. But we are stepping up progress – it’s been a good month.

HHS approves CT application for more insurance exchange funding

Today Health and Human Services, the federal agency tasked with approving and funding state insurance exchanges under the Affordable Care Act, announced that CT’s Level II insurance exchange application has been approved for $107 million, along with new grants for seven other states. A large part of CT’s grant is meant to fund development of an IT system to coordinate “eligibility, enrollment, and information exchange among individuals, employers, insurance carriers, and state and federal government agencies”. This function is sorely needed, long overdue, and hopefully CT’s Health Insurance Exchange will do a good job of designing and procuring this system. Advocates have been critical of many decisions made by the insurance-dominated exchange Board, which includes no independent consumer representatives.

Last chance: Seeking nominations for CT thought leaders

We are refreshing our invitation list for the CT Health Thoughtleader Survey. The survey has been cited by policymakers as a tool in evaluating our state’s progress toward reform. It is part of our CT Health Reform Dashboard. To keep the list robust and ensure a broad reach, we are seeking nominations for the survey. Who do you rely on for information on health reform in CT? Help us improve the tools for our state’s health policymakers and give us your nominations.

Almost half of CT exchange members will pay full price

Almost half of CT residents buying coverage in the new CT Health Insurance Exchange will not get premium subsidies – they will pay the full cost of coverage, including the exchanges’s administrative costs. Small businesses are expected to make up between 14% and 22% of total exchange enrollment. At least 60% of CT’s newly insured under national health reform will be coming into our Medicaid program. Even with reform, up to 197,000 CT residents will still lack coverage. For more, go to CT Health Reform by the Numbers.

August CT Health Reform Dashboard – 13.7% progress

This month CT is again making progress toward health reform. We are now 13.7% of the way toward health reform. Unfortunately we are up only slightly from last month’s 13.2% performance. At this rate, it will take over fourteen years to fully implement reform, but January 1, 2014 is only a year and a half away. Track CT’s progress on the CT Health Reform Dashboard at www.cthealthreform.org

Seeking nominations for CT thought leaders

We are refreshing our invitation list for the CT Health Thoughtleader Survey. The survey has been cited by policymakers as a tool in evaluating our state’s progress toward reform. It is part of our CT Health Reform Dashboard. To keep the list robust and ensure a broad reach, we are seeking nominations for the survey. Who do you rely on for information on health reform in CT? Help us improve the tools for our state’s health policymakers and give us your nominations.

Health Insurance Exchange Board recommends standards for benefit package

Last week, the CT Health Insurance Exchange Board voted on their recommendation for the benchmark essential health benefit (EHB) package that must be offered in 2014 by all individual and small group plans, both inside and outside the Exchange, under national health reform. Federal regulators granted states the ability to define the EHB package, within guidelines. The plan is modeled on ConnectiCare’s HMO package, with additions including coverage for prescription drugs and pediatric vision and dental care. The plan includes all state mandated benefits. Abortion coverage is included but must be paid with non-federal funds. The choice of ConnectiCare’s package was a compromise reached in two Exchange Advisory Committees in a contentious process. The plan represents the middle choice in generosity of benefits and price among the federal options. Thankfully, the Exchange Board honored the process of the two committees; advocates had been concerned that the insurance-dominated Board, that includes no independent consumer representatives, would choose a less generous option. The recommendation is now open to public comment for 30 days.

Exchange Navigator Committee moves into recommendations

Yesterday the CT Health Insurance Exchange Brokers, Agents, and Navigators Committee started the hard work of developing a structure and defining roles for the Navigator Program. Navigators will educate and help enroll potential individual and small business exchange, and Medicaid enrollees. Under the ACA and federal regulations, navigators must have demonstrated ability to reach those three audiences, meet licensure and conflict of interest standards (yet to be determined), and meet certification standards set by the Exchange (also yet to be determined). Staff draft recommendations include two tiers of navigators. Tier 1 Educators will focus on raising awareness of the Exchange and Medicaid options, distribute impartial information about options and enrollment, and ensure cultural competence. They would be paid on a grant/lump sum basis. Tier 2 Enrollers will focus on collecting the information needed to determine eligibility for appropriate programs, assisting in enrollment, and follow up. The committee is still discussing how to compensate Tier 2 navigators. Organizations, not individuals, will be designated as navigators and can apply for Tier 1, Tier 2 or both functions, but individuals acting as navigators will have to receive the appropriate training and certifications. The committee is still discussing how to certify SHOP navigators. The committee also discussed providing training/information opportunities for stakeholder organizations and individuals who are not interested in certifying, or being paid, as navigators but want to help in outreach and public education.

The committee also reviewed new data from Thompson Reuters commissioned for the exchange on CT’s uninsured, Medicaid and likely exchange-eligible populations to help target outreach and education efforts. Initial analysis found that current uninsured and Medicaid populations live in the same communities, and a small number of urban zip codes, particularly in Hartford and New Haven, account for a significant part of both populations. Researchers estimate that there are currently 66,000 adults and 18,000 children in CT eligible for the current Medicaid program but not enrolled. They also estimate that 205,000 adults and 11,000 children will be eligible for subsidies in the exchange. There is a lot of information on citizenship, race/ethnicity, income levels, and the proportion having difficulty speaking English.

CT Health Intern conference July 24th

Breaking into Health: Tapping into Skills and Experience, is designed for anyone interested in breaking into CT’s health landscape to gain valuable skills from health professionals working in the real world of health care and policy. The free conference will be July 24th from 10am to 4pm at the Divinity School at Yale, is co-sponsored by the CT Health Policy Project and Dwight Hall at Yale. Speakers include Comptroller Kevin Lembo as well as reporters, business people, state agency staff, foundations, health care providers, advocates, and budget analysts. Parking and lunch are free but registration is limited. For more information and to register, go to www.cthealthintern.org.

The ACA and what it means for CT consumers and small business

While we are all celebrating the Supreme Court upholding the Affordable Care Act, consumers and small businesses want to know what it means in the real world. The CT Health I-Team has a great piece answering just that question.

Awaiting the Supreme Court: What Could it Mean for CT?

Policymakers and politicians, in CT and across the country, are eagerly awaiting/dreading tomorrow’s Supreme Court ruling on the Affordable Care Act. We’ve outlined a few possible scenarios and the potential impact on CT. All scenarios have an upside, and there is a way through for every possibility. No matter the decision, we are much farther along than before the ACA. Everyone is affected by rising costs, growing un/underinsurance, and lagging quality of care. And more importantly, after the ACA debates, virtually everyone understands that. A lot of important reforms happening now in CT are independent of the ACA and will likely continue. We can continue our momentum for reform. The status quo is no longer acceptable to anyone.

Courant editorial critical of Senate failure to add consumers to exchange board

Yesterday’s Hartford Courant editorial voiced disappointment that the legislature and administration could not agree to add consumer and small business voices to the CT Health Insurance Exchange Board this session. The editorial notes that a bill adding a significant number of both voices passed the House but stalled in the Senate. The editorial notes both the need for the expertise of consumers and the perception that the lack of balance will taint the Board’s work with suspicion.

Thoughtleaders give CT health insurance exchange a C, again

CT thoughtleaders gave our state’s health insurance exchange a C grade again this month. For overall reform CT earned a C+ this month. CT’s reform efforts have not varied much over the last four months, earning a C or C+ in each Thoughtleader Survey. CT also earned a C+ for effort this month, as in the past. This month patient-centered medical homes were the highest rated at a B. Engaging Consumers in Policymaking continued to lag other areas, earning only a D grade. Themes among thoughtleader suggestions to improve progress include engaging consumers and small businesses in policymaking, and fostering collaboration, cooperation and respect. The Thoughtleader Survey is part of the CT Health Policy Project’s Health Reform Dashboard project at www.cthealthreform.org.

Only State Health Care Advocate gets a vote on the health insurance exchange

Budget implementer legislation passed late yesterday included only a provision to give the State Health Care Advocate a vote on the CT Health Insurance Exchange Board. The bill did not add any independent consumer or small business members. While the Health Care Advocate is a respected and valued member, she serves at the pleasure of the Governor. Consumers will still have no independent voice on a board dominated by insurance interests and charged with deciding what health insurance options will be available on the Exchange. Furthermore, without real consumer membership, the Exchange Board does not comply with federal regulations. Despite legislation passed last year prohibiting any Board member affiliated with the insurance industry, three current members have only insurance experience. The vote is particularly disappointing in light of the unanimous and bipartisan approval by the House in the regular legislative session of a bill that would have added two new consumer members, as well as two small business representatives. It is hard to understand why the inclusion of consumers and small business members continues to be such a problem given the broad support among rank and file lawmakers. Ellen Andrews

What is at stake for CT in Supreme Court decision?

A great Health Affairs blog by Sonya Schwartz, of the National Academy for State Health Policy, outlines the likely impact on active states, like CT, of various Supreme Court ACA scenarios. She uses a Richter Scale of impact from 2.0 if the entire ACA is upheld to 8.0 if the entire law is invalidated. It is one of the more readable, but substantive, analyses I’ve seen.

HHS awards HealthyCT $75.8 million loan to develop new statewide nonprofit insurer

Today HHS announced approval of HealthyCT’s CO-OP application to develop a new non-profit insurance company for CT consumers. The federal $75.8 million loan is meant to cover start up costs and reserve funds for the new insurer. The CO-OP opportunity (Consumer Operated and Oriented Plan)was created in the national health reform Affordable Care Act, to foster more competitive markets and develop non-profit, consumer-driven insurance options. The HealthyCT model and application focus on improving the quality, coordination and continuity of care for the citizens of Connecticut, primarily in the individual and small group markets. HealthyCT plans to offer high-quality, coordinated medical care with strong physician-patient relationships at its foundation and encourage the use of patient-centered medical homes. HealthyCT was sponsored by two CT physician organizations – the CT State Medical Society and the CSMS IPA, but will be open to providers willing to work with HealthyCT and meet established criteria. As a non-profit health insurer, any surplus funds will go back into the plan to help keep premiums stable and improve the quality of care.

CT Health Reform Dashboard – CT up to 13.8%

CT has jumped ahead in progress in health reform to 13.8% of the tasks completed, according to the June CT Health Reform Dashboard. This is up from 12.1% last month. While we are closing in on the major January 1, 2014 deadline for many reforms, much remains to be done. At this rate, it will take 4.2 years to achieve reform – down from 5.6 years last month. The dashboard can be found at www.cthealthreform.org.
 

Qualified Health Plan committee date changed

The exchange’s Qualified Health Plan advisory committee will meet Friday, June 8th from 10:30 am to noon replacing the June 13th meeting.

Upcoming Exchange meetings

The CT Health Insurance Exchange Board’s next meetings are June 21, July 19 and August 16 all from 9am to noon. The SHOP Advisory Committee will meet June 12th from 9 to 11am, July 11th from 1 to 3pm, and August 8th from 1 to 3pm. The Navigators Advisory Committee will meet June 12, July 10, and August 7 all from 1 to 3pm. The Qualified Health Plans and Benefits Committee will meet June 13, July 11, and August 8 all from 9 to 11am The Consumer Committee will meet June 13th from 1 to 3pm, July 10th from 9 to 11am, and August 7th from 9 to 11am.

Taking the pulse of CT’s Health Insurance Exchange

As health insurance reform begins to take shape here in Connecticut there are many important elements of implementation that the Health Insurance Exchange Board, their staff and advocate/stakeholders need to focus on. But nothing is more important than educating health care consumers. Securing reasonably priced, quality health insurance is hard enough; how health care reform, and the Exchange, will help consumers is complex. The educational message needs to reach all segments of our population, bridging age, race, gender and geography. One of those critical groups is entry level employees of small businesses that do not provide health care. Recently, the Exchange board hired a marketing firm, which has been reaching out to groups and individuals to collect and mine data, with the goal of educating the public. But sometimes feedback from a "boots on the ground" approach to data collecting is as helpful, or even more helpful, in bringing clarity. I run such a business, providing commercial maintenance services. To that end, a member of my staff and I spent two weeks talking to two people each day as we did our business at area big box home improvement stores. We asked 3 questions: 1. Are you an employer yes / no? 2. Do you have health insurance ? 3. Do you know what the Health Insurance Exchange is? Of the 40 individuals we interviewed, 31 were employees; 9 were small business owners. Not one of the 40 individuals had ever heard of the Connecticut Health Insurance Exchange. Not one of the 31 employees knew about health care reform. Seven of the 9 employers believe that health care reform will increase their costs; 2 employers (interestingly enough) believed that health insurance would be FREE under reform. One individual confused the CT Health Insurance Exchange with the NY Stock Exchange. Our survey wasn’t scientific, to be sure. But it does provide a very telling indication of just how much work needs to be done on brand development and awareness of the Exchange. And we haven’t even touched yet on the complexities of what it is the Exchange will do. Our informal survey highlights just one of the many challenges the Connecticut Health Insurance Exchange is facing. I am hopeful that the new marketing firm, and the Exchange board will make good use of the wealth of knowledge of the many health care advocates. Where small business owners and employees buy their wares might be a good place to get the message out. Kevin Galvin, owner, CT Commercial Maintenance

Insurance Exchange Board meeting notes

The CT Health Insurance Exchange Board met last week – not much happened. Small business owner, Kevin Galvin, and a consumer who has struggled with health care and insurance access gave very moving public comment to start the meeting. There were lots of updates but no actual substantive information. The committee reports were interesting – somewhat different than reports from advocates who attended them. There was an acknowledgement from the SHOP committee that they need to engage small business owners on the committee; they are going to work on that. They also recognize that the measure of their success should be whether more CT small businesses offer benefits rather than enrollment in the SHOP exchange. MA found that while small business enrollment in their Connector has lagged, more small businesses are finding affordable, decent coverage options and offering benefits to their employees. The SHOP exchange could serve as a competitive catalyst to improve offerings in the entire market. There was discussion about having CBIA run the SHOP exchange as well. The Qualified Health Plan Committee is struggling with defining the essential health benefit package and whether to include all the state mandates. There was discussion about the health benefits offered to employees of the exchange; Board members felt strongly that, as soon as the exchange is operational, employees should get their health benefits there, as will members of Congress. Mintz & Hoke continues their efforts to solicit the best ways to sell the exchange to consumers and small business. They are not collecting input for the exchange to use in designing their system but were asked for the feedback they have gotten so far. Their answers were 1) consumers are confused and uncertain, 2) benefit choices must be kept simple, choosing insurance is intimidating, and 3) they are targeting two populations – families (with mainly women making health decisions) and young invincibles. Upon questioning, they agreed with Vicki Veltri’s experience, matching ours, that the most salient fact about consumers is that they are very distrustful of both insurance and of government. The Exchange crosses both issue areas.

CT’s insurance exchange keeps its solid C grade

Again this month Connecticut health care thought leaders gave our state’s health insurance exchange a C on health reform. Fifteen percent of thoughtleaders gave CT’s exchange a Failing grade; the exchange received no A’s. Several suggestions to improve health reform in CT focused on the exchange including “Speed up progress on the exchange”, “Add consumers and small business owners to [the] exchange board”, “Study what Maryland is doing for their exchange”, and “Get a more representative Exchange Board.” The survey list was collected from membership of health-related state councils, board and committees and leadership of health-related organizations. Respondents represented community organizations, foundations, providers, payers, consumer advocates, labor, business people, insurance brokers, and academics. To ensure independent responses, state officials responsible for reform functions were not surveyed. For more, go to the CT Health Reform Dashboard at www.cthealthreform.org.

Exchange fix bill dies in Senate

The bill to bring the CT Health Insurance Exchange into compliance with federal regulations died on the Senate calendar last night as the session ended. The bill would have added two consumer and two small business representatives to the Board’s membership and given the State Health Care Advocate a vote. Currently there are no voting members representing consumers and three Board members have insurance industry backgrounds. The bill passed two committees and passed the House unanimously but was never called in the Senate. The administration has defended their appointments and the composition of the current Board. Board members are appointed by the Governor and legislative leadership. Thankfully one current member, appointed by House Republicans, is a small business owner.

CT Health Reform Dashboard – CT up to 12.1%

CT has jumped ahead in progress in health reform to 12.1% of the tasks completed, according to the May CT Health Reform Dashboard. This is up from 10.8% last month. While we are closing in on the major January 1, 2014 deadline for many reforms, much remains to be done. At this rate, it will take 5.6 years to achieve reform. The dashboard can be found at www.cthealthreform.org.

Upcoming insurance exchange meetings

The CT Health Insurance Exchange Board’s next meeting is May 17th 9am to noon. Upcoming advisory committee meetings include:

• Qualified health plans committee May 14th 9am to 11am 
•  SHOP exchange committee May 14th 1pm to 3pm 
• Consumer committee May 15th 9am to 11am 
• Navigator committee May 15th 1pm to 3pm

All meetings are at tentatively at the Legislative Office Building.
The Consumer committee will also be holding webinars – Stakeholder Discussions – led by Mintz & Hoke, the exchange’s communications firm. The webinars are scheduled for:

• Small Employers May 9th 3pm to 5pm 
• Consumer Session I May 10th 3pm to 5pm 
• Consumer Session II May 16th 9am to 11am 

For information on how to participate, email Kathy Morelli at kathym@mintz-hoke.com

CT small businesses struggle with health benefits

A new survey by the Universal Health Care Foundation of CT found that two out of three CT small businesses can’t afford to offer health benefits to employees. A tiny fraction (6%) of small business owners who don’t offer coverage, don’t want to. Among those that offer health benefits, most have had to shift more costs onto workers. 41% say their inability to offer health benefits is limiting their growth, a majority believes that it impacts their ability to recruit and retain workers, and 28% believe this disadvantages them compared to larger companies. 60% say government should offer an alternative to private insurance. The report delves deeply into the types of coverage offered by CT small businesses and attitudes toward employee benefits. Most are unaware of federal small business tax credits for coverage. Eighty percent of CT workers are employed by small businesses.

Collaboration and transparency key to MD's insurance exchange success

Maryland is widely recognized as a leader in implementing national health reforms, particularly developing their state health insurance exchange well ahead of other states. Health insurance exchanges were created under national health reform as an understandable, fair marketplace for consumers and small businesses to understand and purchase health plans that provide value for the price; federal premium subsidies to make insurance affordable for individuals are only available in the exchanges. In a state visit this week, executive agencies, legislative branch and advocates all agreed that Maryland’s public and inclusive process was key to their success. Maryland passed enabling legislation, created their governance structure, and engaged six inclusive advisory committees last year. As one policymaker said, “It’s not possible that we missed anyone.” Through a transparent, comprehensive process with expert consultant support, those committees and the Board developed a strong set of operating policies that position the state to have a strong, effective exchange in place to help Maryland residents choose the best health plan for their needs by 2014. Using the same inclusive, transparent process, they are moving forward with decision-making and operationalizing those policies. Stakeholders credit soliciting public input often, engaging broad and diverse membership on committees, good communications, and transparent policymaking for their success. Legislation creating the Board excluded members with conflicting interests, creating an expert group with credibility, allowing the state to avoid problems Connecticut has encountered. Stakeholders also credit the decision to create a quasi-public entity with has critical to success. The new entity, outside government, provided public accountability and a fair process but also allowed faster procurement of expert consulting and facilitation services from diverse sources. To keep momentum going and recognizing the huge number of tasks, policymakers decided to make decisions in steps. Early on they finalized decisions in policy areas that achieved consensus, and put off more contentious debates for later such as whether to negotiate with plans to qualify for the exchange or approve any that meet standards. The financing model for the exchange’s administrative functions also remains to be worked out. Maryland is now deciding how to hire, train and certify navigators, to inform the public and assist consumers and small businesses in making the best purchasing decisions.

Bill to increase consumers on insurance exchange board passes House

Yesterday the House unanimously passed a much improved version of HB 5013. The amendment added another consumer and another small business representative to the Board, in addition to the one each in the original bill raised by the Insurance Committee. Also different from the committee version, the bill gives Republicans a voice in nominating the new members. (The only small business person on the current Board was appointed by Rep. Cafero, ranking Republican in the House. There are no voting consumer representatives and three from the insurance industry.) The bill also gives the State Health Care Advocate a vote. Advocates for consumers and small businesses had been calling for this version, adding enough consumer and small businesses representatives to make a difference. Unfortunately, the current Board at its last meeting already made their critical decision about hiring a CEO without a consumer vote. The Governor is now choosing the CEO from among the three names given him by the current Board.

Insurance exchange committee updates

The first meetings of the four CT health insurance exchange advisory committees were largely uneventful and had a lot in common. They were mainly led by consultants, lacked diversity, emphasized principles (already drafted by the consultants), timelines and goals. In three committees, access to outside information was limited and discouraged. In contrast, the Consumer committee appears to be developing a formal process to collect it. In every committee, the consultants emphasized the need to be cost conscious. The Qualified Health Plan committee did not address a very important policy decision, whether the exchange will be an active purchaser of health plans – negotiating on behalf of members as one large entity for better prices and to enhance quality. The Massachusetts connector is an active purchaser and has kept price increase well below the level of plans in the rest of the market. The Navigator committee spent most of its time talking about the role of brokers, agents and other stakeholders, navigator training and certification, and the need for good research on the exchange’s consumers. The latest federal regulations preclude brokers who are paid by insurance companies to sell their products from being paid as navigators inside the exchange. The Consumer committee talked about the Basic Health Program Option and making sure plans are affordable for consumers. Advocates at that meeting also pushed back at consultants’ suggestion that cost cutting had to come at the expense of outreach – using existing resources. (They acknowledged that outreach is often the first to be cut, with an expectation that nonprofits and community groups will do the work within their available resources.) At the Small Business committee the consultants announced that they expect to go out to bid for plans in that exchange later this summer.

Insurance exchange Board meeting update

The CT Health Insurance Exchange Board chose their three CEO candidates to send on to the Governor at last week’s meeting. The decision was made without a voting consumer representative and after another hour-long closed-door meeting. Names of the three chosen were not released; hopefully they do not have close ties to the insurance industry. A bill to add one consumer and one small business representative is making its way slowly through the General Assembly. In an interesting irony, the Board has determined that the general perception of CT stakeholders is that they have not accomplished much. Rather than consider whether the crowd is wise and improve performance, they have chosen to engage their communications consultants to fix their image with a media campaign including postcards, emails, webinars, and a website. Thankfully they have heard from CMS about the need to keep costs under some control and are looking to coordinate with state agencies, especially DSS, and with the federally funded New England IT exchange collaboration. RI, the first state to receive Level 2 exchange funding, did not receive their full request as CMS asked them to reuse available resources. CT’s exchange is reportedly also seeking to borrow a large sum from the General Fund until more federal money is granted and plan to hire nine more staff. The Board was asked to trust their leader and staff and authorize the exchange to enter into an undisclosed $3 million contract. Board member requests for information on the contract, the services to be delivered, the contractor, or the process used to choose them were denied. In good news, they will be engaging a research consultant to develop a better analysis of who likely exchange customers are, where they live, etc.

Connecticut’s insurance exchange gets a C

This month Connecticut health care thought leaders give our state’s insurance exchange a C grade, unchanged from the March survey. Overall reform efforts did somewhat better at a C+,  and a B-/C+ for effort. Medicaid is again the bright spot, earning a B. Health Insurance Market Reform and Data-based Policymaking joined Engaging Consumers in Policymaking in earning D grades this month. Forty percent more respondents answered Don’t Know on one or more issue areas this month, emphasizing the need for better communication and coordination in health policymaking. Asked for suggestions to improve Connecticut’s progress toward reform, several themes emerged including engage consumers in policymaking, smarter policymaking, urgency -- move more quickly, and implement a public option through the SustiNet plan. For more on how CT is progressing toward reform, visit the CT Health Reform Dashboard.

April CT Health Reform Dashboard -- 10.8% progress to date

This month again CT is making progress toward health reform. This month we are 10.8% of the way toward health reform. Unfortunately we are only up from 10.7% last month. At this rate, it will take 48 years to fully implement reform. Track CT’s progress on the CT Health Reform Dashboard at www.cthealthreform.org

Exchange advisory committees begin work

Last week the four CT Health Insurance Exchange advisory committees held their first meeting jointly. The meeting included a very good presentation on the basics of the exchange and a list of the decision points for each committee. The next advisory committee meetings, all public and all tentatively in Room 310 of the Capitol, will be:

Consumer Experience and Outreach

April 10^th  9 to 11am

Brokers, Agents and Navigators

April 10th  12:30 to 2:30pm

Health Plan Benefits and Qualifications

April 11^th   9 to 11am

Small Business Health Plan Options Program (SHOP)

TBD

Experience to inform health insurance exchange outreach

CT has a long and varied history of outreach programs; some worked very well and some were less successful. There is a great deal of experience available to the CT Health Insurance Exchange and their consultants to design a robust program that meets the needs of individuals and small businesses likely to enroll. As individuals will be required under federal law to purchase coverage, and 140,000 state residents will have to buy it on the exchange to access subsidies, it is vital that we learn from experience and not repeat mistakes. We’ve collected some of that experience in a new brief. We offer this experience to the Exchange to help ensure a viable, trusted Exchange is developed that makes serving its customers their first priority.

Insurance Exchange meeting allows limited public comment

Partially responding to widespread calls to respect consumer voices, the CT Health Insurance Exchange Board allowed 12 minutes of public comment at the beginning of today’s meeting. Speakers were limited to two minutes each – there was only time for five. They heard from a struggling consumer, a small business owner, advocates and a representative of the faith community that, while we are grateful for this effort, the process needs to be far more open. Several Board members seemed moved by the testimony and understood that they are missing important perspectives critical if the exchange is going to work. The Board is currently hiring senior staff, developing a budget, beginning to develop a mission statement and guiding principles, and choosing an administrator for the exchange, all without voting consumer input. Mintz and Hoke, the advertising agency hired for consumer input, was criticized by speakers and Board members for soliciting limited input and not reaching out to CT’s well-organized consumer advocacy networks. Their scope is limited to message-testing for the eventual exchange products, not listening to customers about how those products should be designed to meet the demands of the market. They emphasized mass media, which has not historically been successful in outreach in CT, social media and texting. While texting and social media are commonly used between young invincibles in personal communications, it is unclear whether they are effective vehicles to sell health insurance. They are still researching other states’ consumer research efforts and populations eligible for the exchange; unfortunately, it is unclear if there is time for a learning curve. The speaker helping the Board with governance put consumers at the end of the chain of stakeholders (never mentioned small businesses) and equated consumers with providers and health plans in importance. It was clear that Board members have not seen consulting contracts, RFPs or other solicitations before they are finalized. The administrative RFP will be “fast tracked” concerning many consumers and small businesses.  Mike Devine, the only small business owner on the Board, asked whether KPMG, hired for business operations, had investigated overlap with other agencies in CT, and other states. There is likely a great deal of overlap with other states, particularly the New England collaborative, and federal and very well-resourced privately funded programs that are developing innovative enrollment, operations and outreach programs. After an hour and a half of public meeting, the Board went into secret executive session for an hour and twenty minutes. After which they reconvened for less than a minute to adjourn, without voting or reporting on what was discussed in executive session.

Ellen Andrews

CT gets a C for health reform

In a new survey, Connecticut health care thought leaders give our state a C on health reform. The state received no A’s. Connecticut received a slightly better grade, C+, for effort. Connecticut’s Medicaid efforts are a bright spot, earning a B. The worst grade was for Engaging Consumers in Policymaking, averaging a D rating. A significant number of responders answered Don’t Know on one or more issue areas, echoing calls for better communication and coordination in health policymaking. Asked for suggestions to improve Connecticut’s progress toward reform, several themes emerged including engaging consumers in policymaking, limiting the influence of special interests, expanding the health care workforce, and improving policy coordination, focus and leadership. Click here for more detail on the survey. The survey is part of the CT Health Reform Dashboard, tracking our state’s progress toward health reform.

CT Health Reform Dashboard -- 10.7% progress to date

The good news is that CT is making progress. This month we are 10.7% of the way toward health reform. The bad news is that we are up from 10.4% last month. Track CT’s progress on the CT Health Reform Dashboard at www.cthealthreform.org

Bill adding consumer and small business voices to Exchange Board passes Insurance Committee unanimously

Yesterday the legislature’s Insurance Committee unanimously passed HB-5013 with substitute language. The new bill language adds one consumer and one small business representative to the CT Health Insurance Exchange Board and makes the State Health Care Advocate a voting member. The bill will be effective upon passage. The bipartisan bill partially addresses concerns raised by advocates, small businesses, editorial boards and others about the lack of consumer and small business voices on the Exchange. The bill now goes to the House floor.