know about this We can meet the costs of health insurance
in complete details.
Approaching public policy problems seriously requires patience. In the case of dealing with skyrocketing health insurance costs in Connecticut, it takes extreme patience, laser-like focus, single-minded dedication, and loving care, much like what’s required of a surgeon performing brain surgery on a baby in the womb.
We expect surgeons to produce miracles in the operating room. Surgeons often do. Serious politicians can do it too.
The high cost of living in Connecticut is a persistent problem. This year our state fell to 39th on CNBC’s annual list The best states to do business rankings, earning two “F” letter grades for our state economy and cost of living, and one “D” letter grade for the cost of doing business.
Health insurance companies’ recent request for a 20.4% average rate increase for individual health plans next year and a 14.8% average increase for small group plans sold in and out of Connecticut’s Affordable Care Act exchange punched residents in the stomach. It painfully reminded us that our health care costs are also among the highest in the country.
Twelve years after it was signed into law, the continued rate hikes are also a stunning rebuke to the promise of the Affordable Care Act itself.
Real people in Connecticut (self-employed contractors with families, small business owners trying to do what’s best for their under 50 workers, and lots of folks) can’t sleep at night right now because they don’t know how to afford health insurance . .
What can a serious politician do? Immediately stop dealing damage.
Politicians need a Hippocratic Oath.
With sixty-eight benefits and services mandated in health plans, Connecticut ranks among the highest in the country in claims by insurers offering health plans in-state and out-of-market for individuals and small groups. These people make up about 30% of the health insurance market in Connecticut. To be clear, this is the only slice of the market that state politicians can control.
The remaining 70% of the market are individuals and families who get their health insurance from the large corporations they work for like Sikorsky or Pratt & Whitney; those health plans are regulated by federal law and cannot be affected by state mandates.
Each of those mandates has contributed to higher health insurance premiums for the contractor, the small business owner, and the individual. The Connecticut Business and Industry Association estimates that through the 2019 plan year, each enrollee pays an additional $2,085.48 in premium costs due to these 68 benefit mandates.
Furthermore, these mandates go through the legislature without a cost-benefit analysis. For example, in 2022, SB358 (a bill to expand screening for existing breast cancer) and HB5386 (a bill that set the price of epi-pens at $25) passed without a report from the Review Program of Health Benefits, a report that would have answered basic questions about what part of the population would use the benefit, to what extent those benefits were already available and what the cost of those mandates would be for individuals, insurers and employers.
And the Health Benefits Review Program report might have indicated that pricing by politicians or bureaucrats on any product, especially a life-saving medical device like an epi-pen, would create price distortions and shortages in that same product. Economics in a Lesson by Henry Hazlitt will tell you that government price controls are a bad idea.
Another major cost driver is assessments imposed on insurance companies. Among the assessments is the charge for operating the State’s own health exchange, which cost $32 million in 2021. That $32 million was collected from insurers and passed on to the contractor, small business owner and individual enrollees through higher premiums.
Insurers are leaving the Connecticut market. harvard pilgrim is retiring its small group plans, which affected 12,000 enrollees as of January 2023. Connecticare, a health insurance company started 40 years ago by a group of doctors, suffered losses of more than $65 million by 2022 in the individual market.
State officials have tried to innovate, but without serious commitment, the effort is wasted, as evidenced by the project to leverage UCONN to develop a health information network for the state, which resulted in about $20 million going down the drain when it was unceremoniously rejected earlier this month.
Connecticut politicians should look in the mirror when they ask who is driving up health insurance costs in our state.
Once we pass your self-examination, we can move on to the serious work of reforming the health system to offer many choices, high quality, and low cost. We need transparent pricing, payment reform, and value-based health care that aligns health and fiscal outcomes, rather than fee-for-service health care that incentivizes more tests and services.
Simply put, we have the government we deserve. If we want serious politicians, we must be serious citizens. Seriously informed and committed. There is no easy way. We must roll up our sleeves and patiently, step by step, demand better laws and better processes.
Tackling big public policy challenges requires patience, focus, dedication, and care, but it’s not brain surgery. Us they can flourish in Connecticut.
On August 11, I hosted a town hall via Zoom as part of my summer public policy series titled: “Why is health care so expensive in Connecticut and what can we do about it?” A recording of the conversation is available on my legislative website, repfiorello.com
Kimberly Fiorello, a Republican, is serving as State Representative for District 149 which includes the cities of Greenwich and Stamford.