SIM planning Committees Missing True Consumer Representation

The SIM (State Innovation Model) grant process is well into its final development and consumers are not at the table. In March, CT received millions of federal tax dollars through SIM to completely restructure the health care system that covers at least 80% of state residents. The final model design is due to the federal government in just a few weeks. Of the 75 SIM committee seats defining that health care system model, only three represent consumers of health care. Consumers/taxpayers are the ultimate funders of our health care system, and unlike other stakeholders, more than our incomes are impacted – our lives depend on a functional system. With only three seats for consumers, you’d think that they’d be filled by true consumers and independent advocates, those with direct knowledge of the challenges the SIM needs to address. Unfortunately, that is not the case. Since the implementation of health care reform began in Connecticut there has been a very obvious and, in my opinion deliberate, movement to exclude consumers from the decision making process. So few seats being allotted by the SIM committee organizers and the individuals chosen continue the lack of consumer input to our health care system. Connecticut is rich with passionate consumers and knowledgeable consumer advocates. Knowledge, experience and passion that are all being wasted. One would think the SIM leadership would want the very best input from all stakeholders, especially consumers, at the table to develop the best possible product. I guess not. Kevin Galvin Small Business for a Healthy CT

Intern Academy agenda updated

The agenda and speakers list for the June 18th CT Health Intern Academy have been updated. Free and open to anyone interested in learning more about health policy, the event will be June 18th, from 9:30 am to 2 pm at the Legislative Office Building. The agenda includes panels on Health Policy Trends, State & Congressional Advocacy, Health & the Media, Networks & Collaboration and a tour of the Capitol. Speakers include State Comptroller Kevin Lembo, along with small business, nonprofit, lobbying, insurer, broker, policy and fiscal analyst, provider, state legislative and Congressional staff, state agency, community organizer, reporter and social media experts. Lunch and parking are available, but registration is required. The Academy is made possible with support from the CT Health Foundation. For more information, visit www.cthealthinern.org.

Bill directing exchange to negotiate premiums died on House calendar

SB-596, a bill that would have implemented active purchasing in Connecticut’s health insurance exchange, died yesterday without action by the House on the last day of the session. The bill passed the Senate last week. The bill directed exchange staff to negotiate premiums with insurers. Negotiations in California and Massachusetts’s exchanges have kept costs down for consumers and small businesses. According to reports, the insurance industry lobbied heavily against 596. Members of the House worked hard to pass the bill, but were overridden by leadership. Exchange staff was not supportive of the bill. The administration agreed to language in a budget implementer bill that the exchange “may” negotiate premiums with insurers, a largely meaningless move. But in the end, an amendment was added removing even that language.

Anthem proposed rates for inside and outside exchange filed

Yesterday, Anthem’s proposed 2014 rates were posted on the insurance department’s website. Proposed base rates (costs for an average 21 year old in an average plan before adjustment for age, geography and benefit plan) average $296.49 and $440.30 per month for individuals and small businesses respectively. Rates reflect an 8.6% increase over 2013. These averages are for products inside and outside the exchange. Consumers will compare these rates with those proposed by HealthyCT, ConnectiCare and Aetna at $427, $397 and $364 per month for individuals. It is not clear that these numbers compare apples to apples.

Aetna exchange premiums lower than competitors; all higher than CA rates

Wednesday, Aetna submitted proposed rates for Access Health CT, the state health insurance exchange. Averaging $364 per month for individual coverage. By tier premiums average $177 for Catastrophic coverage, $356 for Bronze, $487 for Silver and $477 for Gold. (Yeah, I don’t get that either). Aetna follows HealthyCT and ConnectiCare proposals averaging $427 and $397 per member per month for all tiers. In comparison, the most affordable Silver option in California’s exchange is $276 pmpm, as much as 29% lower than current offerings. California’s exchange negotiated premiums with insurers. Connecticut policymakers still have options to lower premiums in our exchange. SB-596, directing the exchange to negotiate premiums with insurers, is awaiting a vote in the House.

Active purchasing bill passes Senate

This afternoon the Connecticut State Senate passed SB-596, a bill directing Access Health CT, the Connecticut Health Insurance Exchange, to negotiate with insurers to keep premiums affordable for consumers and small businesses. Other states and most large employers negotiate with insurers to control costs. The bill passed 23 to 12 on a party line vote. Republicans offered five amendments to dilute or delay negotiation which were defeated. Advocates for consumers and small businesses supported the bill in testimony; insurers were opposed. The bill now travels to the House for a vote.

Insurance exchange rate proposals in for HealthyCT

Insurance premiums for HealthyCT, the new nonprofit health insurer co-op, have been posted on the insurance dept.’s website. HealthyCT is the only insurer that has submitted rate proposals for 2014 so far, despite an April 30th due date. Average monthly premiums for individuals will be $427/month and for small groups $445/month. While the benefit plans will change next year and previous prices are not strictly comparable, in 2010 individual premiums in CT averaged $306 per month. 2014 rates will vary by customer based on age, residence, and the plan selected; rates must still be approved by the insurance department. Policymakers have options to control premium increases but they must act soon to be effective.