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Consumers Still Want A Public Option, Affordable Care

by Christine Stuart | Nov 28, 2012 10:41am
(7) Comments | Commenting has expired
Posted to: Town News, Hartford, Health Care

Christine Stuart photo

Gathering at the Hartford Public Library for conversation on health care

More than 100 people gathered Tuesday at the Hartford Public Library to quiz Health Insurance Exchange officials about what they’re doing to make health insurance more affordable and accessible.

The exchange will be the virtual marketplace where consumers will be able to shop for insurance starting in Jan. 2014. It is expected that one in 10 Connecticut residents will purchase coverage through the state’s insurance exchange once it’s up and running.

“With all due respect, I still think we’re focusing on the wrong thing,” Gretchen Vivier told Kevin Counihan, CEO of Connecticut’s Health Insurance Exchange. “Getting everybody insurance is not the same thing as getting everybody health care.”

Counihan didn’t disagree, but he said they’re related.

“Most people actually get health care by having health insurance,” he said. “Research actually shows people who are insured get different care than people who are uninsured.”

“What are you doing to try and encourage getting something more like a public option?” Vivier asked.

As for the public option, which was included in first iteration of the Affordable Care Act, Counihan said they’re not doing anything about it.

“That’s just not our charge,” he said. “Our job is to implement the Affordable Care Act and I can tell you that’s challenging enough right now.”

Christine Stuart photo

Kevin Counihan, CEO of the Health Insurance Exchange Board offers his opinion

Advocates haven’t given up on creating a public option for Connecticut, but Gov. Dannel P. Malloy squashed the idea during his first year as he sought to close a $3.6 billion budget deficit. Over the next two years the state will face an estimated $2.13 billion deficit.

Without a public option, consumers who attended the meeting Tuesday were concerned about exactly how affordable health insurance will be under this new construct.

Two subcommittees of the Health Insurance Exchange Board so far have been unable to reach agreement about whether the state should negotiate with the health plans coming into the exchange.

Healthcare advocates are encouraging the state to negotiate with insurers coming into the exchange, while state officials aren’t convinced they have enough information about the population that will participate to force the companies to negotiate.

If negotiations for benefits occur they will focus on both rate setting and prices.

Alta Lash, executive director of United Connecticut Action for Neighbors and a member of one of the subcommittees, said she thinks it’s wholly unacceptable to ask the consumer to bear the responsibility of figuring out pricing of specific medical services.

“The pricing system is so complicated that everyone including the exchange has to weigh in on this issue,” Lash said.

“You can’t just say it’s up to the consumer now to be more price conscious.”

Counihan said he doesn’t disagree, but he’s just trying to look at how change occurs and sometimes change occurs at the grassroots level when people demand it. He said the exchange will help drive change.

At the moment, health care providers often don’t know how much it costs to render certain services.

A federal grant will help the state set up an all-payer claims database where consumers will be able to see the pricing for certain procedures.

As far as affordability is concerned, one woman in the audience said health insurance currently costs her 17 percent of her income and next year it will be 20 percent of her income at the same time she will be receiving fewer benefits.

Counihan said the Affordable Care Act tries to address that by capping the amount consumers pay based on their income and family size.

A family of four making $92,000 a year will be capped at $692 per month under the legislation, which is 9 percent of income.

“What the Affordable Care Act tries to do is ameliorate some of that with some subsidies,” Counihan said.

Also the legislation allows small businesses with fewer than 50 employees to get a tax credit of up to 50 percent of the premiums, if they decide to offer their employees health insurance.

Businesses with more than 50 employees will have to pay a penalty of $2,000 per employee, per year if they decide not to provide coverage.

Counihan, who was working in Massachusetts in 2006 when that state mandated insurance coverage for its citizens, said the number of employers offering insurance increased from 70 to 77 percent in the first year.

“While I don’t think anyone can predict how employers will act in our state or anywhere else, I just give that as some background,” he said.

The conversation Tuesday at the Hartford Public Library was the first of seven that will occur throughout the state.

The next meeting will take place Thursday at Waterbury City Hall. Conversations also are scheduled to take place in New London, New Haven, New Britain, Stamford, and Bridgeport.

Click here for a list of dates and locations.

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(7) Comments

posted by: DirtyJobsGUy | November 28, 2012  12:28pm

This will be an unmitigated disaster.  I’m a small businessman and have negotiated the small group (<5) market for 20 years so I know what is happening.  I also buy all the other types of insurance (workmans comp,general and professional liability etc).  We have staff from 20 to 70 years old so I know what it costs.

Bottom line, state and federal interference in the market have made it progressively more expensive and difficult to obtain insurance.  They do it by adding “freebies” for political gain and by trying to legislate affordability.  Neither works.

Remember this when you go to your doctor. You are being given personal attention by someone who has gone to both undergraduate and graduate school, had extensive low paid apprenticeship (residency), and has to comply with increasing amounts of paperwork.  In other professional fields that person would charge at least $300 per hour.  You are getting an astoundingly complex and sophisticated service and people expect it to be free.  You can either pretend to control costs and drive competent MD’s out or we can reduce the amount of overhead we place on the system.  Your choice folks.

posted by: kenneth_krayeske | November 28, 2012  12:30pm

Medicare for all. Everybody in, no one out.

posted by: JusticeCT | November 28, 2012  10:26pm

The Exchange is facing a crisis and doesn’t seem to know it.  Because of Republican opposition in Congress, the federal reform law doesn’t provide enough in subsidies to bridge the gap between our (outrageously bloated compared with anywhere else in the world) insurance costs and the incomes of people who need coverage.  Do the math for yourself.  Say you’re a family of 4, and pick an income somewhere between $31,000 and $92,000, a group that is likely to be uninsured today.  Plug your numbers into the Kaiser Foundation Subsidy Calculator here: and imagine adding those thousands of dollars in new insurance expenses to your budget.  Lots won’t, and will go uninsured.  If the Exchange was truly “consumer-focused” it would be screaming about this impending crisis.  Figuring out how to cut insurance costs and increase subsidies would be Job One.

posted by: christopherschaefer | November 29, 2012  8:17am

Why AZ Gov. Jan Brewer is rejecting the state-exchange OPTION: “’Though I am a steady advocate of local control, I have come to the conclusion that the State of Arizona would wield little actual authority over its “state” Exchange,’ Brewer said. ‘The federal government would maintain oversight and control over virtually every aspect of our Exchange, limiting our ability to meet the unique needs of Arizonans and the Arizona insurance market.’ She said a state-based exchange would be too costly, even though the federal government would repay start-up costs, and that she does not have enough information about the structure of a federally run fallback versus a state-based system.”

posted by: ConnVoter | November 29, 2012  9:20am

The first sentence of this piece should have begun, “More than 100 people gathered at the Hartford Public Library to insist that someone else pay for their health care coverage…”

Ken, why would you insist that everyone be a part of Medicare?  I would rather not have the federal government involved in my health care choices in any way.  If you’re asking for a public “option,” can I also “opt out” of Medicare and get my Medicare tax back?  Are you insisting that I should be required to get health care coverage from someone I don’t want to give it to me?

posted by: DrHunterSThompson | November 29, 2012  1:09pm

Not everyone should have a Mercedes, or a beach house, or drink expensive wine - that stuff you earn - however, every citizen should have equal access to healthcare at the same cost, whatever that would be.

there is absolutely no reason that I have heard that makes whatsoever not to have every citizen covered.


posted by: ConnVoter | November 29, 2012  7:28pm

Hunter, health care costs money.  You are trying to repeal the laws of supply and demand, and that’s not possible.  A root canal does not cost the same as a heart transplant. 

As for your last question, there is no reason that I have heard, not one, that suggests that having the government cover everyone in a single plan makes sense.  I should be able to opt out of the government’s doomed efforts to be a health insurer, just as I can opt out of the Postal Service if I want FedEx.