May 13, 2022
  • May 13, 2022

Steep Hikes Proposed for Certain CT Medicare Plans

By on September 1, 2021 0

With some Connecticut residents facing health insurance increases of 20% or more, only a few seized the opportunity Tuesday to demand change – although lawmakers and other advocates blasted health insurers for raising tariffs during the COVID pandemic while pocketing billions of dollars in profits.

The Connecticut Insurance Department testified Tuesday before setting rates for 11 health insurers covering nearly 223,000 people.

About half of these people buy insurance on their own through the Access Health CT plans offered by Anthem Blue Cross & Blue Shield and ConnectiCare under the Affordable Care Act.

Many of Connecticut’s largest employers underwrite their own health plans, using insurance companies only on an outsourced basis for wellness programs and claims administration. The rates for these self-insured plans are not subject to approval by the Connecticut Department of Insurance, which sets the prices after a review of income, costs and actuarial assumptions by underwriters.

At Tuesday’s hearing, Dan Pflug, a resident of Easton, told the Connecticut Department of Insurance he was paying nearly $ 34,000 for an Anthem policy covering his family, with the company seeking an increase of 12. % for 2022. must be paid before any reimbursement for treatment.

“You have the power to stop this freight train,” Pflug said on Tuesday. “What’s the point of approving premiums every year when there are no more Connecticut citizens who can afford insurance?” “

If the plans are approved according to insurers’ demands, individual rates would increase from 1.1% to 22.6%, depending on the plan. Small business plans would increase between 2.8% and 23.6%.

Prior to Tuesday’s hearing, the public had a 30-day window ending in mid-August to file written statements on the proposed plans. The Connecticut Department of Insurance plans to make final decisions in September, before enrollment opens for 2022 coverage starting November 1.

State Senator Saud Anwar, D-South Windsor, said the increases exceeded annual earnings gains for many people, especially those living paycheck to paycheck.

“The past year and a half has been a nightmare for the average citizen of our state and for most businesses,” Anwar said on Tuesday. “Some of them [insurers] made billions of dollars in profits as people in our communities died. “

An actuary from Point32Health – the successor carrier to Harvard Pilgrim Health Care after its merger with Tufts Health Plan – said drug costs were behind the increases.

“We are seeing a significant usage trend on the pharmacy side, driven by high cost drugs,” said Besart Stavileci, Actuarial Manager at Point32Health. “This is what has guided our overall trend – and quite significantly.”

Senator Tony Hwang, R-Fairfield, advocated alternative approaches to controlling costs, such as a price benchmark system used in Massachusetts where Point32Health is based, or bypassing pharmaceutical distributors altogether by creating a system to import cheap drugs from Canada.

“The growth in costs is out of control and insurance premiums are often the size of a monthly mortgage payment,” Hwang said. “It’s not just this rate increase – it’s the cumulative increase over … [years] that has overtaken the affordability and sustainability of families and businesses.

An actuary from ConnectiCare said his company’s average increase is in line with cost increases passed on to it by doctors, hospitals, pharmaceutical companies and other health service and product companies.

In addition to the usual inflation in drug prices and other costs, carriers are bracing for an increase in clinic visits due to people refusing to see doctors during the COVID-pandemic. 19 and the increase in “behavioral health diseases” in the words of the Connecticut Department of Insurance.

On average, the rates for the 11 individual health plans reviewed would increase 8.6 percent, an increase from the 6.3 percent increase this year. Small business plans would increase 12.9% on average, following an 11.3% increase this year.

Connecticut health care advocate Ted Doolittle has warned that runaway deductibles represent an additional expense the department must factor into final rates.

“The process in which we are engaged [in] is truly one of the only tools that Connecticut families need to be heard from, ”Doolittle said. “We saw the [rate] trends are rising like a hike to Mount Kilimanjaro – and the health insurance industry hasn’t been able to offer … competitive healthcare prices to families in Connecticut. “Why” is a complicated question. “

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