Monday, November 23, 2015
New Haven Register op-ed yesterday. CT’s Medicaid program is remarkable in actually lowering the cost of care for members, while improving the care they receive. Legal aid’s role is not usually to compliment the state, but these two attorneys felt compelled to applaud the accomplishments. Other states should take notice. Read more
Friday, November 20, 2015
$469 million in 2014 insurance premium rebates will soon be going back to US consumers including 22,166 CT residents, according to CMS. CT rebates will average $177 per family. Since 2011, under the Affordable Care Act, insurers are required to spend at least 80% of individual and small group insurance premiums on medical care or activities that improve health. Large group insurers must spend at least 85% of premiums on health care and activities. Under the law, insurers that do not meet this standard must rebate excess administrative costs to consumers. Over $2.4 billion has been returned to US consumers since 2011. Rebates come either directly to consumers or to their employers to benefit employees. Since 2011 the percent of compliant, fairly priced coverage has increased every year, necessitating fewer rebates.
Monday, November 16, 2015
167 of the 1,215 HUSKY parents that lost coverage last year were able to buy insurance from the health insurance exchange. Unfortunately 32 former HUSKY parents initially signed up for insurance through AccessHealthCT, but later lost coverage because they didn’t pay their premiums. It is not clear if they found other coverage or weren’t able to afford coverage at all and are now uninsured. It is unclear how many have been able to stay on HUSKY because they remain eligible in another category. At least three HUSKY parents cut off the program left their original households and now are eligible as single households. Council members expressed concern about the potential implications of the cuts for keeping families together. Another 18,389 HUSKY parents are scheduled to lose coverage on July 31, 2016 unless the state reverses the cuts.
We also heard that the backlog of pdf applications is now gone, so application delays should be far lower. Total Medicaid eligibility has fluctuated over the last year because of the pdf problem, the shift to MAGI income eligibility and HUSKY parents’ cuts. As of last month, 716,833 state residents were enrolled in Medicaid.
Tuesday, November 10, 2015
At today’s Health Care Cabinet, we heard about the RFP for health care planning made possible by passage of SB-811 this year. Section 17 of the law directs the Cabinet to compare mechanisms to improve health care value in Connecticut looking to other states and assessing what would work best here. The plan for the grant is thoughtful, focuses on engaging all stakeholders to collect the best ideas, and improving communications across CT’s health care landscape. The plan holds great promise to address the shortfalls of past and current reform efforts. Advocates sent a letter in July supporting the project and offering our help.
We also heard from SIM about a CMS-led summit meeting and strong federal pressure toward narrowly defined, strong payment models. It was pointed out that evidence of effectiveness to date for these new payment models is very sparse and mixed. While CT should learn from federal and other states’ experience, we have to chart a course that makes sense for our state. Our Medicaid program has reversed our history of poor performance and is now saving money, improving quality, increasing access to care, and improving consumer experience of care. No one wants to jeopardize that progress. SIM leaders disagreed saying that CT can chart its own course, but that course will align with federal directives.
Monday, November 9, 2015
moving public testimony on Fluoroquinolon—Associated Disability (FQAD). We also heard doubts about the effectiveness of this class of antibiotics that is prescribed over 30 million times in the US each year. FQs were first approved by the FDA many decades ago, before better effectiveness tests. New studies question the effectiveness of FQs in treating infections compared to placebo. At the hearing, FQAD sufferers and family members described serious, but somewhat rare, neuromuscular, psychiatric and cardiac effects and deaths from taking just a few pills, generally in previously very healthy, active people. Many were given the drug as a precaution, and never had an underlying infection. We also learned that previous changes to strengthen warnings on the drug label have been ineffective; prescribers and consumers were unaware of the risks. Drugs companies that developed FQs minimized the risks and questioned the integrity of disability reporting, because most reports come directly from consumers rather than professionals. The committees recommended even stronger label language, including the risks of disability, but also asked the FDA to consider a public/prescriber education campaign about the risks, measures to ensure FQs are used only as second line therapy, and to promote informed consent by consumers using the medication.
Wednesday, November 4, 2015
Brainard Fund brochure or call 211 and ask.