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ConnectiCare Takes Steps To Leave The Exchange

by | Sep 12, 2016 5:55pm () Comments | Commenting has expired | Share
Posted to: Health Care, Insurance

ConnectiCare, which threatened last week to leave the state’s insurance exchange if the Insurance Department didn’t reconsider its rate request, already terminated its contract with Access Health CT. 

The company had until 5 p.m. today to tell Access Health CT whether it would participate in the exchange in 2017, but Access Health CT said it already submitted its request to terminate its contract with the exchange last week.

“Last Friday, AHCT received a letter from ConnectiCare informing us that they are terminating their agreement and exiting the state’s healthcare exchange. This letter has been forwarded to the Connecticut Insurance Department for regulatory review,” Lt. Gov. Nancy Wyman and Access Health CT CEO James Wadleigh said Monday in a joint statement.

However, the insurance company, which has nearly 50,000 customers on the exchange, “is actively working to stay on Access Health CT,” Michael Wise, ConnectiCare’s president and CEO, said Monday in a statement. “We have asked Access Health CT to extend their deadline so we can continue to work together.”

The company did not respond to requests for more information regarding its termination letter.

ConnectiCare asked the Insurance Department early Monday morning to reconsider its rate request after a New Britain Superior Court judge denied the company’s request for a temporary injunction.

The Insurance Department said it received ConnectiCare’s request for an expedited hearing, but it’s still trying to determine the “interrelationship between this new administrative appeal and the Superior Court litigation before moving forward.”

All parties involved said it was “complicated” and struggled to explain how this might possibly end, either with further court action or administratively with insurance regulators.

The company originally requested a 14.3 percent rate hike, but on Aug. 23 revised it to 27.1 percent. At the end of last week, regulators approved a range of rate increases from 15.4 and 24.8 percent, with an average of 17.4 percent. The company’s on-exchange plans cover 47,597 people.

Connecticut is one of 13 states with state-based marketplaces created under the Affordable Care Act that don’t participate in the federal Healthcare.gov marketplace.

If ConnectiCare leaves Connecticut’s exchange, the only company left will be Anthem.

Matthew Katz, executive vice president and CEO of the Connecticut State Medical Society, said any loss of an insurance company is a problem for the exchange.

He said if Anthem was the only company left in the exchange then they would be able to dictate “cost, quality, and access” in a way that could be determinantal to the consumer.

Already, Katz argues that Connecticut is seeing what happens when competition disappears. Earlier this year, UnitedHealthcare announced it would no longer participate in the exchange and the Insurance Department told HealthyCT, the nonprofit co-op, that it didn’t have enough capital to continue past the end of 2016.

Katz said he doesn’t think consumers would be seeing the price increases it saw this year, if UnitedHealthcare and HealthyCT were still part of the exchange. HealthyCT has about 40,000 policyholders. UnitedHealthcare had 1,477 Connecticut enrollees.

Late last week, Wadleigh tried to put a positive spin on the possibility ConnectiCare would be exiting the exchange.

“While it’s true that competition benefits the consumer, in this case there could potentially be a silver lining for the residents of Connecticut,” Wadleigh said Wednesday. “Anthem could create a more diversified risk pool which could help them control and help stabilize the cost of the various policies it offers to customers throughout the state.” 

But healthcare advocates said that’s not exactly honest.

“We know what a monopoly does to health care,” Ellen Andrews, executive director of the CT Health Policy Project, said. “Prices go up and accountability is lost.”

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