Some Good Healthcare Ideas, but Bad Price Tag

The Hospital and Healthcare Roundtable bills that have been a central theme this session will continue to play a large role in the final days of session. While many of the proposals didn’t make it through the committee process, many of them have been given a second life in SB 811.   

Providing consumers with more information about their healthcare choices so they can make more informed decisions is one of the many changes to the healthcare landscape included in SB 811, which the Senate passed this week.   

This bill, which consists of a new 90-page amendment that was voted on the same day it was posted for review, includes many topics–including hospital mergers and acquisitions, electronic health records, surprise billing, facility fees and substantive disclosure requirements on providers and insurance carriers.

One of the sections of significant concern requires the state's exchange to post cost and quality information on its website. While consumers could certainly benefit from cost and quality information, the problem is who will pay for the website.

There does not seem to be any funding mechanism for this website in the language of the bill which leaves the state's exchange assessment as the default funding mechanism. 

The state’s exchange is funded by assessing small employers and individuals a fee of 1.35% (but it could increase at any time) on their health insurance premiums. The assessment, which amounted to about $40 million last year, is on all small employers and individuals regardless of whether they utilize the state’s exchange.

If the state’s exchange must establish this website and needs additional funding to make it operational, then they may raise the assessment to pay for it–meaning insurance premiums for small employers and individuals could rise again. That’s ironic, considering at least part of goal of the website is to ultimately address Connecticut's high healthcare costs. 

What’s more, even though this information may be used by everyone in Connecticut it would be funded by just a portion of the market–small employers and individuals. Most of the market health insurance market is offered by larger employers, who are self-insured, and not subject to the assessment. 

It’s also important to remember all the ongoing work that’s funded, in part, by the employer community, such as the State Innovation Model (SIM). 

SIM is focused on payment reform and whole patient centered care and receives $3.2 million through an assessment hitting smaller employers. The All Payers Claim Database (APCD) (with the goal to provide cost and quality information to consumers) is run by the state’s exchange. Both of these programs are positive initiatives but come with price tags. 

Continuing to ask smaller employers to pay for them is a significant concern. Instead, new programs should be paid for from existing appropriations or the General Fund.

For more information, contact CBIA’s Jennifer Herz at 860.244.1921 | jennifer.herz@cbia.com | @CBIAjherz