Bills filed to fix insurance exchange and strengthen premium rate review

Sen. Joe Crisco, Co-Chair of the Insurance and Real Estate Committee, has filed bills to protect consumers in health reform. An Act Concerning the Duties of the CT Health Insurance Exchange directs the exchange to actively negotiate premiums with insurers on behalf of consumers. Other states are using negotiation to keep premiums more affordable. An Act Concerning the Insurance Department’s Review of Health Insurance Premium Rates directs the department to consider consumer out-of-pocket costs, affordability, provider rates, executive compensation in approving insurer rates and to directly monitor provider network adequacy. Both concepts are included in 31 Ways to Save Money in CT’s Health Care Budget.

CT Insurance Exchange standard plan proposal too expensive for consumers

The draft standard plan proposal for the CT Health Insurance Exchange includes copays of $40 to $45 for a physician visit (CT 2011 average $23.79), $150 ER copays, and deductibles up to $3,000 for individuals and $6,000 for families (CT 2011 average $1,331 and $2,500 respectively). Better, more affordable plans are currently available in CT on eHealthInsurance.com. It is important to note that the Exchange will be marketing their plans to CT’s uninsured, who couldn’t afford the more reasonable options available now. In what is becoming standard process for the Exchange, the proposal was developed by Exchange staff with industry insiders in non-public meetings. The draft was open for public comment until today but it was never released to the public or posted on a public website. Some Exchange Board members didn’t know anything about the process. Click here for our comments.

Mickey Herbert joins Harvard Pilgrim

Former ConnectiCare CEO, Mickey Herbert, has joined Harvard Pilgrim Health Care as a consultant. Harvard Pilgrim has applied for a license to expand to CT’s insurance marketplace. He resigned from the CT Health Insurance Exchange Board a month ago, adding to growing conflict of interest concerns. Concerns have been raised about Board members ties to and investments in insurance companies despite strong conflict of interest limits in state law.

Five large CT insurers interested in exchange

Aetna, Anthem, ConnectiCare, HealthyCT (the new nonprofit co-op plan), and United all sent letters of intent to the CT Health Insurance Exchange signaling their intent to participate. The other large insurer in the state, CIGNA, does not participate in CT’s individual market, according to exchange staff. Harvard Pilgrim did not submit a letter, but may be awaiting licensure. While not binding, the response is very good. As advocates predicted, there was little need to worry about insurers not participating in the exchange. Advocates have criticized the exchange for designing policies very favorable to insurers, lax in accountability, and unaffordable for consumers and small businesses.