June web quiz

Test your knowledge of substance use in CT. Take the June CT Health Policy Web Quiz.

HealthFirst Authority update

Today the Authority tried to narrow down the options they will consider for study through the rest of the process. The Chairs began with their list of issues that everybody agrees on. It is long:
Strong prevention and health promotion component
Medical home
Electronic medical record and health information technology
Enrolling everyone who is eligible for public programs
Management of chronic illness
Incentives for healthy lifestyles and wellness
Transparency – most emphasis on data for state policymakers to make decisions (if they will) but expanded to include information for consumers in response to a question
Evidence based practices
Improving Medicaid reimbursements – recent increases were not enough
Patient safety
Employer and individual contributions
Addressing workforce shortages
Members also suggested adding Medicare cuts, universality, military health care cuts, consumer education, sustainability, adaptability, increasing federal reimbursements, and access to specialty care.
They then moved onto components that may not be unanimous. They noted that the legislation requires the Authority to consider single payer universal health care and universal primary care options. They also agreed to model the CT Health Insurance Policy Council’s proposal. Other ideas included:
· Maintaining employer and Medicare coverage
· Expanding Medicaid
· Moving SAGA into Medicaid
· Insurance pooling – including what subsidies would be needed
· Shared responsibility (employers, government and individuals) as in Healthy San Francisco, this model includes undocumented immigrants
· Incentives for quality and wellness and support for Medical Home Services
After the list was read, there was silence as most in room waited for the debate to begin. We weren’t disappointed. Perspectives and concerns were predictable. Insurers want a cost benefit study of insurance mandates and lauded Florida’s new barebones policies. There was a great deal of support for studying how a Healthy San Francisco-style model would work in CT. A suggestion to pilot it in an urban area led to concerns about two tiered care. There was no real consensus on which options to move forward. Important decisions were put off until the next meeting. At the next meeting, the members will also each get a copy of the latest Health Affairs – we’ll see if it helps. They will also discuss financing vehicles and an individual mandate – I can’t wait.
Ellen Andrews

New Kaiser Blog Watch

Every Tuesday and Friday, the Kaiser Daily Health Policy Report will feature “Blog Watch”. Recognizing that blogs have become an integral part of health policy coverage, kaisernetwork.org will now summarize the best of the blogosphere. To sign up for Kaiser’s Daily Updates, click here.

Pooling bill update

First, the good news. The Attorney General has issued an opinion on HB-5536, House Majority Leader Donovan’s bill to allow municipalities, small businesses and nonprofits to buy into the state employee plan. His formal legal opinion is that the bill will not increase costs to the state, a concern that reportedly has the Governor considering vetoing the bill. The bad news is that the reason it won’t raise costs is because municipalities, small businesses and nonprofits can’t join the state employee pool, but must form completely separate pool. The separate pool must include the same rich benefit package as the state employee plan, which as the Courant points out, could price many municipalities, small businesses and nonprofits out of the new pool or discourage any insurers from offering the new plan. It is also unclear how this separate pool is different from the Comptroller’s MEHIP program which has been providing coverage to small businesses and nonprofits since 1996. The Comptroller’s office operates the state employee plan covering 200,000 state employees, retirees and dependents using that buying power to leverage lower rates for MEHIP members.
Ellen Andrews

Summer reading

To get ready for this weekend and the unofficial start of summer with its long days of reading, we have added to our Book Club. In between your Beach Reads, try these.

Made to Stick: Why Some Ideas Survive and Others Die – interesting, engaging stories that help all of us make sure that what we are trying to say gets heard
Sick: The Untold Stories of America’s Health Care Crisis – and the People Who Pay the Price – an inspiring book that combines policy wonkery with the stories that make it matter
Redefining Health Care: Creating Value-Based Competition on Results – I expected to hate this book. I disagree most of the time with everyone who recommended it to me, but it changed the way I look at the health care system. The business lobby and consumer advocates have a lot more in common that we know.
Listening is an Act of Love: A Celebration of American Life from the StoryCorps Project – An amazing project collecting history that would otherwise be lost and an exceptional demonstration of the power of storytelling
Maxed Out – a documentary that explains the tragedy of consumer credit and bankruptcy – especially when you consider that half of bankruptcies are due to medical bills
Better – a collection of essays that describe what medicine can become if we are smarter
The Secret History of the War on Cancer – outlines in meticulous detail how the powers-that-be have focused massive attention on treating cancer, but very little on addressing the causes, even covering up conflicts of interest and preventing important protections of our health

These are the newest Book Club recommendations. Check out the whole list.
Have a great weekend.

Pooling Bill rhetoric heats up

Rep. Chris Donovan’s proposal to allow municipalities and small businesses to buy into the state employee plan passed the House and Senate easily. But proponents are concerned that the Governor will not sign the bill. The concept is that bringing thousands of municipal, small business and non-profit employees together with into the same health purchasing pool as the 200,000 state employees, retirees and dependents will achieve significant savings. Cities and towns could use that money to fill budget holes and reduce property taxes. Rep. Donovan has been visiting with city officials across the state to generate interest in the plan.

However, this year the state was very fortunate to negotiate no increase in rates with the three participating health plans that cover state employees when premiums are rising 6 % nationally. That $54 million in state budget savings would be threatened if this bill is signed into law, according to the insurers. Anthem says adding municipalities and small businesses would add “adversity in mix and utilization” and new administrative costs. Anthem will have to recalculate rates and expect an increase of $24 million under the proposal for the state employees they cover. OPM Secretary Genuario says that there is no time to re-bid the contracts as the old ones end June 30th and that with a projected $53 million deficit this year the state cannot afford to lose any savings. Upon researching the proposal, New Haven city officials didn’t find the promised $8.6 million savings, but rather that they would pay slightly more to cover city workers in the state employee pool than they are paying now.
Proponents have been holding several press conferences, featuring small businesses that would save money under the plan, calling on the Governor to sign the bill. The proponents argue that enlarging the state employee pool should reduce prices. Comptroller Nancy Wyman has called in top officials of the three state employee insurers, Anthem, HealthNet and United Health Care, to explain their claim that rates will increase. Today’s lead Hartford Courant editorial urges the Governor to veto the bill, noting that in addition to New Haven, Danbury also found that joining the state employee pool would cost the city $5 million rather than the promised $2.8 million savings. The legislature’s calculation did not include retirees, according to the city. When Massachusetts opened their state employee pool to municipalities few took advantage, finding it more costly. The Courant recommends that the state hire independent actuaries to determine the costs to the state and to cities and towns. The bill has not yet reached the Governor’s desk.
Ellen Andrews

Archive of web quizzes

Many people have asked if our web quizzes from previous months are available on the website. They are now, click here for quizzes back to 2001.