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 tonegotiate 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.

Other state exchange premiums better than expected, Connecticut needs to act

Premiums for next year in other state exchanges are coming in and they are getting better news than Connecticut. Vermont and Rhode Island exchanges are seeing no rate increases and improved benefit packages. Maryland’s and California’s increases are far less than expected. Rates for Oregon and Washington actually dropped, in some cases significantly. In Oregon, two insurers withdrew their proposals to submit new lower rates to match competitors.

So far in our state, ConnectiCare and HealthyCT have proposed monthly average premiums of $397 and $427 for individuals in the exchange. It is estimated that individual premiums in our state averaged $306 per month across all markets in 2010 and eHealthInsurance.com offerings in February 2012 averaged $207 per month in Connecticut. It is important to note that uninsured Connecticut residents couldn’t afford even these rates.

The Connecticut exchange rate proposals are now under review by the insurance department and other insurer proposals may be coming. But there are several options available to Connecticut policymakers to control rates in the exchange; many have already been adopted by other states. Policymakers need to move quickly to help keep insurance affordable for Connecticut consumers and small businesses.

Health Policy Basics updated for June 18th CT Health Intern Academy

Our CT Health Policy Basics module has been updated, in time for the June 18th CT Health Intern Academy. 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.

We’ve moved and juvenile justice art show

Our co-working space, The Grove, has moved around the corner. We are now in huge, beautiful, vintage architectural space at 760 Chapel Street in New Haven, across from Elm City Market. Until June 15, The Grove is hosting The Complete Picture, a show of art by young people in the juvenile justice system presented by the CT Juvenile Justice Alliance. The reception is Wednesday, May 29th from 5:30 to 7pm.

ConnectiCare joins health insurance exchange

Yesterday ConnectiCare filed individual and small group 2014 rates for Connecticut’s health insurance exchange. ConnectiCare joins HealthyCT, the new nonprofit co-op, in participating in the exchange. ConnectiCare plans to charge average premiums of $397 per member per month for individuals and $716 pmpm for small groups. HealthyCT’s proposed rates average $427 pmpm for individuals and $445 for small groups. Rates will vary by customer based on age, residence, and the plan selected. Rates must still be approved by the insurance department. While the benefit plans will change next year and previous prices are not strictly comparable, in 2012 individual coverage for CT on eHealthInsurance.com averaged $207 pmpm. Policymakers have options to control premium increases but they must act soon to be effective.

Intern Academy agenda online

The agenda and speakers list for the June 18th CT Health Intern Academy are now online. 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.

Free Dental Clinic Bridgeport June 7, 8

The 2013 CT Mission of Mercy free dental clinic will be at the Webster Bank Arena, 600 Main Street in Bridgeport Friday and Saturday, June 7 and 8. The clinic serves Connecticut’s uninsured and underserved residents who often have no other option for dental care. 1,605 volunteers delivered $1.3 million in donated care at last year’s clinic in Danbury. The clinic served 2,008 people from 168 communities.

Connecticut hospital charges vary widely

New data from CMS shows that prices charged by Connecticut hospitals for the same procedure vary widely, by as much as three fold. An analysis by C-HIT found that Yale-New Haven Hospital charges $85,902 for a cardiac pacemaker while Manchester Memorial charges $22,493 for the same procedure. Stamford Hospital, featured in a recent Time magazine article on extreme health care pricing, charges $25,493 to treat pneumonia while Charlotte Hungerford charges only $8,177. The data gives hospital charges, and the lower prices Medicare pays, for 100 common procedures. Medicare, Medicaid and private insurance plans pay less than charges. However uninsured patients are usually billed the higher charge price.

Connecticut back to a C on health reform

Connecticut health care thought leaders give our state a C on health reform again this winter; down from a C+ earlier this year. Connecticut maintained our C+ for effort in this survey. Among issue areas only Medicaid improved again. Connecticut lost ground on the health insurance exchange, health insurance market reform, and public education. The overwhelming suggestions to improve progress are to engage consumers in policymaking (on every survey in the last year), improve the policymaking process, especially transparency, work on affordability and improve the CT Health Insurance Exchange. The Thoughtleader survey is part of the CT Health Policy Project’s Health Reform Dashboard.

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.

2013 CT Health Intern Academy June 18th in Hartford

Learn valuable skills from health professionals working in the real world of health care and policy at this year’s CT Health Intern Academy. The event will be June 18th, from 9:30 am to 2 pm at the Legislative Office Building. Free and open to anyone interested in learning more about health policy, the event 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 free, but registration is required. The Academy is made possible with support from the CT Health Foundation. For more information, visit www.cthealthinern.org.

Cabinet meeting update: SIM project described, exchange plans offering low rates to doctors, Charter Oak redux?

Yesterday’s Cabinet meeting focused on the state’s $2.8 million State Innovation Model (SIM) grant. The plan is to develop a grant proposal by the fall to create a multi-payer approach to design care delivery and payment reforms that touch 80% of CT residents. The project will test innovative models to lower costs and maintain or improve quality. (We have 31 ways to start that.) McKinsey consultants and others have been hired to guide the project which will be headed by a planning committee with three workgroups focused on developing coordinated state models for care delivery, payment, and HIT. The Health Care Cabinet will offer stakeholder input. We are promised all materials and meetings will be completely public and transparent. In a separate discussion concerns about the CT Health Insurance Exchange were raised. It was reported that physicians are being offered Exchange contracts from insurers with payment rates significantly below commercial rates. Exchange staff reported that they do not regulate or monitor provider payment rates but require the plans to comply with network adequacy standards. It was noted that there are many ways that providers can be listed on a panel but not accept appointments. In fact, this is exactly what happened in the capitated HUSKY program and was only uncovered with a secret shopper survey. The exchange has rejected conducting such a survey to monitor real access to care. Concerns were raised that low provider rates combined with high costs, that will leave many young, healthy state residents out of the exchange, will lead to the same dynamic that now plagues the Charter Oak Program -- skyrocketing premiums and plummeting enrollment levels.

Still waiting for insurance exchange rates, UnitedHealthcare is out

Rate proposals by insurers planning to participate in CT’s health insurance exchange were due to the Insurance Dept. last Tuesday, but none have been filed according to the Hartford Courant. However HealthyCT says they filed with the department on Friday. The exchange is blaming federal regulations and delays. UnitedHealthcare notified the exchange last week that they will not be participating in the exchange, leaving Anthem, Aetna, HealthyCT, and ConnectiCare. Insurer rates have been eagerly anticipated by advocates and others hoping for affordable premiums. Concerns about rate shock have been heightened by 25% increases in rates submitted to Maryland’s exchange. Several options are available to the exchange and state policymakers to keep premiums affordable, but some require legislative action. The legislative session ends in four weeks.

Book Club: The Health Care Handbook

Book Club: The Health Care Handbook American health care is complicated, so byzantine that few who work in the system even understand its reach and rules. Two medical students from Washington University in St. Louis have performed a massive public service in writing this book. It is a clear, understandable, practical guide for any audience, and at 226 pages, remarkably brief. Highly recommended. Check out the CT Health Policy Book Club.

Health Insurance Rate Shock: What Connecticut Can Do

All indications are that Connecticut health insurance costs will rise significantly next year. Fortunately there are several tools available to policymakers to mitigate that trend for Connecticut consumers and small businesses who will be mandated to secure coverage as of January 1st. A new brief outlines state affordability options including a stronger state MLR limit, active purchasing, reinsurance, capping rate increases, limiting insurer losses, and state supplemental subsidies. It is also critical to address the underlying causes of rising health costs that drive insurance prices including misaligned payment incentives, overtreatment, poorly coordinated care, waste, excessive administrative costs, and consumer disengagement. Affordable insurance coverage is critical for successful health reform. State policymakers should use every available tool.

May CT Health Policy Webquiz: 2014 CT Insurance claim costs

Test your knowledge of health insurance claims estimates for next year. Take the May CT Health Policy Webquiz.

We are up to 21.5% of the way to health reform in CT

CT policymakers have completed 21.5% of the tasks necessary for health reform; most are due on Jan.1st of next year. Medicaid and some evidence of movement toward affordability on the insurance exchange accounted for the progress in May’s Health Reform Dashboard. CT biggest problem is ensuring new hopeful signs from the insurance exchange are realized.