Insurance

Advocates ask CT insurance department to reject proposed rate hikes

Yehyun Kim :: ctmirror.org

Health Care Advocate Ted Doolittle speaks during an Aug. 30, 2021 press conference to criticize proposed health insurance rate hikes. Attorney General William Tong, left, and State Comptroller Kevin Lembo stand behind.

Several residents, advocates and elected officials on Tuesday urged the state’s insurance department to reject proposed increases in health insurance rates for plans set to begin next year – including plans offered on Connecticut’s Affordable Care Act exchange.

“Most of you are insulated from the consumers’ ire, but there is ire out there,” said Diane Keefe, a Norwalk resident. “I am paying $43,200 a year for a family of four with $5,000 deductibles to Aetna, and I am on Cobra. This is unsustainable. Families are suffering, and there should be no increase.”

State Sen. Saud Anwar, D-South Windsor, called the suggested increases “discriminatory.”

“It’s going to negatively impact the people who are poor, and then that automatically translates into the minorities in our state. That is going to lead to more people being uninsured,” he said. “The last year and a half has been a nightmare for the average citizen in our state and for most businesses. We are not in the position to be able to survive an increase of this capacity.”

The proposed average rate increase for individual health plans next year is 8.6%, compared to a request of 6.3% in 2021. The suggested rate hikes range from 5.1% to 12.3%, depending on the policy.

For small group plans, the proposed average rate increase is 12.9%, compared to 11.3% in 2021. The recommended rate hikes range from 7.4% to 15.8%.

Anthem Health Plans and ConnectiCare Benefits Inc., which sell individual and small group policies on the exchange, Access Health CT, are both seeking higher rates.

Anthem has asked for an average hike of 12.3% for its individual plans that cover 28,701 people. ConnectiCare Benefits is requesting an average increase of 7.4% for individual policies that cover 81,852 residents.

Both are also seeking rate hikes for small group plans. Anthem asked for an average increase of 11.5% for policies that cover 25,529 people, while ConnectiCare sought an average hike of 13.6% for plans that cover 1,786 residents.

Ten insurers are also selling policies off the exchange. The proposed increases vary by plan.

“Some of these [proposed rate hikes] are something that we have not seen in our salary increases,” Anwar said. “The average individual in our community is not making that kind of increase in their salaries or their capacity to pay. Neither are the businesses in that position at this point.”

Proposed rate hikes are not always approved. Last year, for example, Anthem Health Plans had asked for a 9.9% average increase in its individual plans, which served 22,071 people through Access Health CT. The insurance department approved an increase of 1.9%.

ConnectiCare Benefits Inc. asked for an average hike of 5.5% in its individual plans on the exchange, which at the time covered 75,174 customers. The insurance department signed off on a decrease of 0.1%.

In 2019, Anthem asked for a 15.2% average increase on individual plans. The insurance department approved a 6.5% hike for those policies. The same year, ConnectiCare requested a 4.9% increase on individual plans. The insurance department instead signed off on a 2% average increase.

Rep. Tom Delnicki, a Republican from South Windsor, told state officials that they should review the insurers’ requests with “the magnifying glass, the fine-tooth comb, the microscope.”

“Simply put, these increases are unsubstantiated and just plain wrong,” he said. “It’s time to stand up for the people of Connecticut and send a message to those requesting these increases by denying each and every one of them.”

Carriers have attributed the proposed increases to rising demand for medical services and the swelling cost of prescription drugs, among other trends. They also pointed to an increase in morbidity and expected severity of claims because of delays in care during the pandemic.

Additionally, the insurers cited recent legislation, including a bill adopted last year that caps a 30-day supply of insulin at $25, as a reason for the recommended hikes.

At Tuesday’s hearing, they reiterated some of those concerns.

“What we consider to be the most significant challenge facing the market [is] the increasing cost of health care,” said Steven Ribeiro, regional vice president of sales for Anthem Blue Cross and Blue Shield. “One of the key factors driving up the overall cost is the ever-escalating cost of prescription drugs, particularly new drugs and those that treat serious conditions. While Anthem appreciates their importance, these extraordinary, expensive treatments, like cell and gene therapies, bring additional costs into the health care system that must be reflected in our premiums.”

Insurance Commissioner Andrew Mais said Tuesday that many residents had written to his department inquiring why carriers weren’t charging unvaccinated residents more. He posed the question to insurers: “Why would the people who have chosen to be vaccinated have to bear any increased costs for those who have chosen not to be vaccinated?”

The answers were mixed.

“I would say there probably are very heavy logistical issues with how we monitor that,” said Steve Schneider, executive director of service operations for Aetna. “How do we know who to charge? How do we verify someone is vaccinated? I would also say that while COVID is obviously a huge issue for all of us, the impact on prices has probably not been huge compared to the trends that we see in some of the other things.”

“Under the Affordable Care Act, there are certain allowable rating factors. And COVID vaccination status is not an allowable rating factor,” added Neil Kelsey, vice president and chief actuary for ConnectiCare. “So we’re precluded by the ACA and by Connecticut statute from using that as a rating factor.”

Some attendees took issue with the setup of Tuesday’s hearing. Insurers spoke and fielded questions from state insurance department officials for the first three hours. Appointed and elected state officials were then able to testify. And last in line to speak were residents and advocates, who were each given three minutes, while public officials had five.

“We object to an unfair regulatory approach that does not explicitly consider affordability for Connecticut families and small businesses,” Jill Zorn, senior policy officer for the Universal Health Care Foundation of Connecticut. “Even today’s hearing … illustrates the fundamental power imbalance of a process designed to protect insurers while ignoring the interests of consumers and not taking them into account as much as they should be. Connecticut families and small businesses who will pick up the tab on these rates have no official voice in this hearing, and no reassurance that even their comments today will have an impact on the decisions that will be made.”

Residents were also invited to submit written testimony to the insurance department or comment on the proposed rate increases via the state’s website.

Actuaries with the insurance department are reviewing the carriers’ requests. As part of the review, they examine trends in unit cost (total expenditure incurred by the company), utilization of services, and expected severity of claims.

Once completed, the department can approve the full proposed increase, reject it or amend it to a different number. The final changes will be published in September.

Open enrollment for 2022 health plans begins Nov. 1.