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.