Healthcare: With Big Changes Ahead, Cost Increases Avoided
Uncertainty over federal healthcare legislation—what it will cost and how it will actually work in Connecticut—should have led to caution in the 2013 legislative session on healthcare.
Yet the business community ended up expending considerable effort to defeat numerous measures that would have complicated implementation of federal legislation (the Affordable Care Act) and made it much harder for businesses to afford health benefits for their employees.
Despite the cost impact, many new health benefit mandates were proposed this year. (Health benefits are state laws requiring insurance companies to cover specific medical procedures or services.)
Under federal changes, any additional mandates directly impact the state budget and employers in the form of higher premiums.
Overall, the business community succeeded in communicating the significant impact of the costliest health benefit mandates that lawmakers considered. However, three new or modified mandates (albeit with minimal fiscal impact) were adopted:
- SB 465 requires a new type of test for newborns once a reliable test is approved by the U.S. Food and Drug Administration
- HB 1029 grandfathers coverage for those already diagnosed with autism under the current definition, since it is expected that the new diagnostic manual will impact the autism diagnosis
- HB 6546 was revised from its earlier, more costly version to now cap co-payments for physical therapy sessions to $30 per visit for in-network services.
The legislature also proposed many other measures that would further complicate implementation of federal healthcare legislation and make health insurance more expensive in Connecticut.
While businesses, in combination with coalitions formed during the session, succeeded in educating legislators about the detrimental impact of these bills this year, the proposals may return in the next legislative session.
One of the most problematic bills that fortunately did not gain enough momentum, HB 6614, would have required businesses to reimburse the state if their employees or their employee's dependents opted in to the state’s subsidized HUSKY program.
A bill exempting physicians from state anti-trust law—a perennial proposal at the Capitol–was not acted on by either chamber. Proposed by the Labor Committee, HB 6431 once again met immediate criticism from the state’s attorney general based, in part, on an earlier Federal Trade Commission opinion letter that warned such a proposal would lead to increased cost and decreased access.
The chairs of the labor committee requested another opinion on HB 6431 from the Federal Trade Commission, which arrived a day before the session ended. It said that the bill would very likely benefit only physicians and harm healthcare consumers.
Federal healthcare legislation requires that insurers authorize and pay for existing prescriptions during an appeal process. But SB 599, which the Senate approved but the House didn’t, went even further to require immediate authorization and approval for any new prescriptions during an appeal process. It not only raised safety concerns but also negated the cost savings of step-therapy protocols.
HB 6612 would have driven up costs by discouraging healthcare providers from participating in networks—just as state and federal policy is trying to get greater provider participation in networks.
For more information, contact CBIA’s Jennifer Herz at 860.244.1921 or email@example.com.
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