Sunday, April 22, 2012

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.

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