National health reform standards may not cover college health plans

The Wall Street Journal raises the question of whether the notoriously inadequate health plans offered to college students will be covered under national health reform regulations. While these plans are generally inexpensive they typically include caps on coverage and would not meet new standards on how much of premiums must be spent on health care. A study from Massachusetts found that profits were five times higher on student health plans than other insurance. About 80% of US college students are covered by public or private health plans. The article highlights the cases of students who fell through the cracks of questionable insurance often leaving them with massive medical debt. It is important to note that as national reform also includes an option for young adults to stay on their parents’ policies through age 26.
Ellen Andrews

Survey predicts employee share of health insurance to rise 12.4% next year

Hewitt’s annual survey of large US employers estimates health costs to be $9,821 per worker in 2011, up from $9,028 this year. While total costs are expected to rise 8.8%, workers’ share of that bill will rise 12.4%, continuing a trend of shifting more costs onto consumers. From 2001 to 2011, while total premiums will have doubled, consumers’ share of costs will have tripled. Hewitt blames higher medical costs – both increasing prices and higher utilization by a slightly older workforce due to layoffs – and national health reforms. Hewitt estimates that immediate reforms, such as removing annual and lifetime caps on claims and allowing children to stay on their parents’ polices until age 26, contributed 1 to 2% to the increase. The report acknowledges that national reform also provides new opportunities to reduce long term cost trends, but that the impact of those measures won’t be realized next year. To keep down their costs employers plan to raise employee cost sharing (increasing co-insurance and deductibles), changing how they subsidize dependent coverage and monitoring eligibility, holding venders accountable, and expand disease management and wellness programs. A growing number of employers plan to use penalties such as higher premiums and cost sharing to encourage workers to enroll in health improvement programs.
Ellen Andrews

Webinar cancelled

Unfortunately, the Malloy campaign has cancelled tomorrow’s webinar. We apologize for any inconvenience.

Gubernatorial candidates on health care

Connecticut’s next Governor will face significant challenges in health care as well as exciting new tools and opportunities under national and state health reform efforts. The candidates have both now released their plans. Click here for Dan Malloy’s plan and here for Tom Foley’s plan.
Join us for a webinar with Dan Malloy and Nancy Wyman next Tuesday at noon. The candidates will answer your questions. The Foley and Boughton campaigns received a similar invitation.

236,400 CT residents eligible for health care tax credits in 2014

A new report by Families USA estimates that $830 million in tax credits will be coming to 236,400 middle income CT residents to help pay for health coverage. The credits are structured on a sliding scale, targeted toward those who need assistance the most. The majority of people who will benefit have incomes just over twice the poverty level (currently $44,100/year for a family of four). 92% of people eligible for the credit are in working families. About half the likely beneficiaries will have been previously uninsured; they only receive the credit if they enroll in coverage. The other 57% will go to help pay skyrocketing health insurance bills for currently insured low income families. The credits are refundable (taxpayers don’t have to have large tax bills to get the full credit), and available as consumers pay their premiums; they will not have to wait until they file taxes to get the relief.
Ellen Andrews

CT medical home Medicare application in

The Office of State Comptroller has taken the lead in filing an application for CT to participate in a new Medicare option. The project would join the state employee plan, Medicaid, Medicare and private insurers in an exciting plan to build patient-centered medical homes for over a million state residents eventually. The Governor, DSS, the SustiNet PCMH Advisory Committee and dozens of consumer and provider groups have all signed on to support the application. The plan is to start with ProHealth, a large primary care practice with 74 sites across CT, but to reach out to other accredited PCMH providers soon after. Beyond the core PCMH functions, the project includes special focus on discharge transitions, expanding primary care for nursing home residents, extended hour facilities, and care coordination for patients with multiple chronic conditions. CT has also agreed to collaborate with a new multi-state PCMH collaborative sharing data, evaluations, technical assistance, and best practices. There is so much here to be excited about, but the best part may be the cooperation across agencies and provider groups. This project can serve as a foundation for thoughtful reform in Connecticut.
Ellen Andrews

Webinar: Dan Malloy and Nancy Wyman on health care issues

The next administration faces both great challenges and great opportunities to improve health care in Connecticut. Join us for a webinar September 28th at noon to hear from Dan Malloy and Nancy Wyman, Democratic candidates for Governor and Lieutenant Governor, on health care issues. There will be time for your questions at the end and, as always, a video of the webinar will be posted online. To register for the webinar and to be notified when the video is posted, go to https://www1.gotomeeting.com/register/260958984 After registering you will receive a confirmation email containing information about joining the Webinar.

CT uninsured rate up to 12%

The Census is reporting that CT’s uninsured rate rose from 10% in 2008 to 12% in 2009, an increase of 43,000 residents without coverage. Employer sponsored coverage levels held steady despite rising unemployment, possibly because of generous federal COBRA subsidies. While Medicaid numbers dropped during the study period, HUSKY enrollment grew and has grown faster since. Click here for the CT Health Policy Project’s brief.
Ellen Andrews

CT insurers propose double digit rate hikes

Once again CT health insurance companies are asking the CT Insurance Department for permission to charge very large premium increases, more than 20% in many cases, according to the Hartford Courant. Predictably, insurers are blaming rising medical costs and national health reform. Members of CT’s Congressional delegation and the Attorney General are objecting. The largest increases would fall on new businesses and individuals. CID has not yet ruled on the increases. In their applications, the insurers outline how much they believe various provisions in national reform will raise premiums above the effect of rising medical costs. Anthem estimates that requiring coverage for children with pre-existing conditions will raise premiums 4.8% and removing annual caps will cost 22.9% more. The federal government and independent analysts estimate the impact of national reform on premiums for next year at 1 to 2%. I hope that someone at CID remembers these estimates and looks back next year to see if they were realistic. Especially as they consider next year’s proposed increases.
Ellen Andrews

CT lags in health IT adoption

If you’ve been avoiding the health information technology debate (it can get a bit technical), yesterday’s CT Mirror has a great analysis. While electronic medical record adoption is slow across the US, it is glacial here in CT. There are several reasons nicely outlined in the story; we need to address them all. Health IT is critical to improving quality, reducing waste, avoiding errors, coordinating care (patient-centered medical homes), accountability, and so much more. How often have you heard that we don’t have the data we need in CT to do any meaningful system planning or even to know where the problems are? We don’t know what is really working and what is just hype. Health IT is critical to all this and more. The feds have devoted billions to the effort, but it is still a slow slog in CT. The problem is that busy providers, especially primary care practices, don’t have the time or resources to invest in health IT. It will help them, but it will help the rest of us far more. We need to support them – with money, resources, and political chits to make this happen. Hopefully, the next administration is listening.
Ellen Andrews

HealthJusticeCT launches website

Health Justice CT, a new social networking project to address racial and ethnic health disparities in CT, has launched a website, www.healthjusticect.org. It is interactive, gathering news, research, events, and online conversations. The resources section is particularly helpful. Health Justice CT is funded by the CT Health Foundation. Check back often to learn more.

CT residents need to eat more fruits and veggies, but we are doing better than most states

The good news is that CT residents eat more fruits and vegetables than most Americans, according to today’s MMWR. The bad news is that our consumption of fruits dropped each year from 2000 to 2009; vegetable consumption was somewhat steady. Last year, 37.6% of us ate fruit two or more times a day and 28.5% ate three or more vegetables each day. We all should be, but the US averages were 32.5% and 26.3%, respectively. Compared to other states, we do better in fruit consumption (5th) than veggies (11th). Eating fruits and vegetables is important for maintaining healthy weight and reducing the risk of many illnesses.


Between 1987 and 2007, the percentage of obese adult Americans more than doubled. A new analysis by CBO estimates that we could reduce health spending increases 3% by 2020 if we could level off rising obesity rates; we would save 4% if we could return to 1987 levels.
Ellen Andrews

Two job openings

The health policy sector of the economy is doing its part to reduce unemployment. The Bridgeport Child Advocacy Coalition is seeking a Director of Public Policy and eHealthConnecticut is seeking a CEO.

The new CEO of eHealthCT will lead the nonprofit organization dedicated to creating a sustainable, secure, private health information exchange in our state. eHealthCT is looking for a senior health care executive with an entrepreneurial approach. For more information, click here.

BCAC’s new Director of Public Policy will help the community coalition develop effective advocacy campaigns in areas such as early childhood, K-12 education, after-school programs, economic self-sufficiency and health care. Applicants should have experience in community organizing, policy and legislative advocacy, and coalition building. For more information, email information at cthealthpolicy.org.

The jobs are important, but so is the context. While the organizations seem very different, they have common goals. Connecticut needs to find more ways to bridge the gaps between policy cultures.
Ellen Andrews

Conversion to risk corridors in HUSKY seems less likely

As reported by Christine Stuart at CT News Junkie, in a meeting yesterday the Executive Committee of the Medicaid Managed Care Council considered HUSKY financing options outlined by DSS at the last Council meeting. The budget passed earlier this year includes $76 million in savings to move HUSKY from the current capitated system to a non-risk model where the state pays all medical bills and pays a fee to an outside company to administer the program. DSS favors a model that retains the current system with some, potential limits on profits and losses. Representatives from CMS on the phone emphasized that they do not favor any option and are not pushing CT into managed care. DSS also wants to extend whatever financing/managed care model is adopted for HUSKY to all Medicaid populations including the elderly and people with disabilities. All agreed that the current system is “broken” but without more information, they could not recommend any option. Most felt strongly that any new payment system should reward quality and value.
Ellen Andrews

Will Charter Oak survive?

An interesting story by Arielle Levin Becker at the CT Mirror asks whether Charter Oak will survive after Governor Rell leaves office. The best thing about Charter Oak is that people with pre-existing conditions are not excluded from coverage; under national health reform, that exclusion will be prohibited in all health insurance in 2014. It is also unclear whether some of Charter Oak’s limits in coverage that consumer advocates have criticized will be allowed in any coverage plan. There is also a question about the sustainability of funding. Currently, there are concerns that Charter Oak’s monthly $307 premiums are sufficient to sustain the costs of care for patients attracted to a safety net plan. As Charter Oak is now linked to HUSKY, insurers can spread the costs over a much larger pool. (An audit by the Comptroller’s Office found that the plans are overpaid in their HUSKY rates). If HUSKY converts to a non-risk model as is called for in the budget, in which plans are paid only an administrative fee and the state pays all medical bills, Charter Oak’s premiums will have to reflect just the higher risk of those consumers alone. Given the looming $3 billion deficit next year, it is unlikely that the state will subsidize the program. In the article, all the candidates for Governor expressed doubt about Charter Oak’s future.
Ellen Andrews

Win Win -- state cigarette tax increased revenue and reduced smoking

The $1/pack tax increase in cigarette taxes implemented last October brought in over $100 million while seven million fewer packs of cigarettes were sold, according to the Hartford Courant. It was expected that increasing taxes would both increase revenue and reduce cigarettes sold, but this increase brought in $5 million more than projected. The increase brought total taxes to $3/pack in CT, fourth highest in the nation but behind neighboring NY and RI. Over the last five years, the number of state residents who smoke and the number of packs sold has declined; about 17% of CT adults smoke.
Ellen Andrews

Almost half of Americans use a prescription medication each month

Forty eight percent of Americans reported that they had taken a prescription medication in the last month, according to new numbers from the CDC for 2007-2008. That number is up from 44% in the last ten years. Not only are more of us taking medications, but we are taking more drugs. The percentage of Americans taking five or more drugs grew from 6% to 11%; seniors are three times more likely to be taking five or more drugs than just one. Children and seniors are more likely to be taking medications; people without insurance or without prescription coverage are less likely. Americans without a regular place to access care are almost three times less likely to be taking prescription medications. The most commonly used medications were bronchodilators for children (for asthma), CNS stimulants for adolescents (attention deficit disorder), antidepressants for adults, and cholesterol lowering drugs for seniors. Prescription drug spending grew 3.2% from 2007 to 2008; that growth is expected to accelerate reaching 7.7% by 2019.
Ellen Andrews

Forty seven CT employers qualify for early retiree reinsurance program

Nationally less than one in three large firms offer health benefits to retirees. Premiums and deductibles for early retirees can be four times as much as for younger workers. National health reform included $5 billion for a temporary reinsurance program to help subsidize employer-sponsored retiree coverage for early retirees over age 55 but not yet eligible for Medicare. The program covers 80% of the costs of care for individuals between $15,000 and $90,000 in claims. HHS just approved the applications of forty seven CT employers for the program including the state employee plan. The plan is intended to continue until 2014 when state insurance exchanges will offer everyone affordable options. However, analysts estimate that the $5 billion appropriation is not enough and may run out as soon as 2012.
Ellen Andrews

September webquiz -- CT teens and risky behavior

Test your knowledge of CT teens and risky behavior. Take the September CT Health Policy Webquiz.