Exchange meeting update

Monday morning the CT Health Exchange Board held a special meeting by phone with only a few days notice and only noticed on their website. The purpose of the meeting was to increase, yet again, costs for consumers in the exchange. They reduced the prescription deductible in the unsubsidized silver standard plan to $400 from $500 but increased the total deductible to the legally allowed out-of-pocket maximum of $6,250. They also increased the prescription deductible and out-of-pocket maximum for the subsidized silver plan as well. The increases were never sent to the advisory committees, which voted out the former plan by a narrow 5 to 3 margin. Staff again blamed the high cost of health care in CT and the federal actuarial value calculator, but not insurance mandates. In conversations with other state exchanges we are not hearing about problems with the actuarial calculator. Despite comments about reluctance and “tied hands”, the Board unanimously approved the latest version of higher costs. Staff also clarified their decision to charge the specialist copay for prenatal visits. Apparently, after reaching out to CT and national physician societies, insurers and researching CT’s market and other states, they found that prenatal care is considered preventive and carries no copayments under the Affordable Care Act. The staff deferred to the federal law and will communicate to plans that they should not charge copays for preventive prenatal care. They also confirmed that this issue has no impact on the actuarial value calculator.