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.