OP-ED | Insurance Exchange Should Be Serving Consumers and Small Businesses, Not Insurers
One of the goals of national health care reform was to make health insurance more affordable and accessible to individuals and small businesses, and to make the coverage offered more easily understood and transparent for the consumer. As the owner and operator of a small business for more than 30 years, I am counting on the Exchange’s ability to bargain and to foster competition to make more affordable, quality insurance available to my employees.
So it was more than disappointing, last week, to see the board that governs the Connecticut Health Insurance Exchange voting to forgo competitive bidding for insurers wishing to offer products there; to accept the lowest possible standards for plans allowed under federal law; and to let the insurers know those standards before the insurers even apply (something the state doesn’t do in its contracting process.)
The board also watered-down efforts to ensure there are enough doctors, hospitals and clinics in the plans’ networks, and against a monitoring study, used in other states, to make sure that doctors on insurers’ lists really are available to provide care.
In short, worried that insurance companies would not apply to sell their plans here, the Exchange Board decided to accept all applicants, not negotiate prices, or check to make sure applicants have the ability to provide the health coverage, or moving forward, whether those insurers have actually provided the services.
I’ve submitted many a bid for work over the years, I’ve seen a lot in three decades, but the Exchange Board’s abdication of all standards and oversight in the bidding process would not happen anywhere in the business world.
If this is news to you, you are not alone. The process has been anything but easy to understand or transparent. In fact, if I were not a member of the committee, I would never have known.
More importantly, why should consumers and small businesses care about these votes?
We care because on Jan. 1, 2014, every person will be required to have health coverage. In Connecticut, 140,000 uninsured state residents will be required to buy insurance through this exchange to get federal affordability subsidies.
Small businesses have been at a disadvantage for years, unable to get the price advantages that large companies get when purchasing insurance for larger pools of employees. The Exchange was to have provided those businesses with a more affordable way to buy insurance.
If last week’s vote stands, and the Exchange does not bargain or provide oversight, the Exchange has little to offer any of us.
In addition to not providing the health care reform we desperately need, the Exchange board is wasting our tax dollars. To date, the board has received $116 million in federal tax dollars to design this system. Half of the board’s members are public officials, and several others are representatives of the insurance industry. There are no independent consumers on this board that is using federal tax dollars to make decisions that will have a grave impact.
With implementation of the Affordable Care Act, Connecticut has an historic opportunity to provide coverage for the uninsured and to offer relief to struggling small businesses. We have been given the federal funding and the tools to develop a source of affordable, decent health coverage for hundreds of thousands of state residents. Or we can allow the Exchange to give away the store to insurers.
It is not to late to change direction. Connecticut’s elected officials, those who appoint members of the Exchange board, can exert some leadership and urge the board to serve consumers and small businesses instead of the insurance industry that has brought us skyrocketing premiums and diminishing health care coverage.
Kevin Galvin is the chair of Small Business for Healthy Connecticut.