Connecticut Health Insurers Defend Rate Spike As Critics Mount
Two Connecticut health insurers on Wednesday defended proposed rate increases for 2020 as customers and consumer advocates urged state regulators to put the brakes on steadily rising costs.
ConnectiCare Inc. and Anthem Health Plans Inc. told the Insurance Department at a hearing that the elimination of the individual mandate, the policy enacted as part of the Affordable Care Act, or Obamacare, has led to fewer individuals buying insurance in the past year. President Donald Trump and the Republican-controlled Congress dropped the requirement in 2017 that Americans purchase health insurance or pay a fine.
Those who choose to not buy insurance tend to be younger and healthier, "thus putting additional upward pressure on the remaining individual risk pool" of older and sicker people, said Rob Kosior, chief operating officer of ConnectiCare.
A ceaseless rise in medical and prescription drug costs also is driving up health insurance costs, the insurers said.
Anthem is seeking an average increase of 15.2 percent in the individual market and and 14.8 percent in the small group market, which comprises businesses with 50 or fewer employees. ConnectiCare has proposed a 4.9 percent increase in the individual market and 4.8 percent on average in the small group market.
The plans discussed at the hearing cover about 147,000 Connecticut residents, Commissioner Andrew Mais said. Without an approximately 3 percentage point increase related to a recently reinstated federally required health insurer tax, the proposed increases of 14 rate filings by 10 insurers are less than last year's, he said as the Insurance Department released details in July of the proposed new rates.
"In addition to the federal tax, ongoing rising cost of health care is a key driver of health insurance premium rate increase requests," Mais said.
Kosior told regulators that other cost drivers are "larger and more dominant hospital systems and physician groups," drug pricing at "astronomical levels," new regulatory requirements with more taxes and coverage mandates and state regulations that discourage emergency service providers from contracting with insurers.
"We believe that given these facts, the rates that we have filed are appropriate," Kosior said.
Steven Ribeiro, regional vice president of sales at Anthem, said programs that have previously been funded by the state, such as "easy breathing" that helps people with asthma, needle exchange programs and lead prevention education are now funded by assessments on insurance companies. These and other initiatives account for 1.2 percent of Anthem's individual rate request and 1.5 percent for small group insurance.
"It is important to understand consumers who pay insurance premiums fund these worthwhile programs," he said.
Claudio Borea, a retired nuclear physicist from Wethersfield, said the hearing is "really pointless."
He urged regulators to endorse a public option health care policy that allows individuals to choose government-directed insurance that typically provides greater coverage at a lower cost. "If you want better outcomes, you need to have better options," he said.
But Mais told Borea the Insurance Department regulates the industry according to state law and does not advance policy, which is the jurisdiction of the General Assembly.
"It's not up to us to change the system," the commissioner said.
State Rep. Tom Delnicki, R -- South Windsor, compared health insurance increases to compounded interest by raising costs at an escalating rate, one on top of others previously approved. "Every year we have an increase piled on another increase," he said.
State Sen. Saud Anwar, D-South Windsor, urged the Insurance Department to hold increases to the federally mandated health insurer tax and average cost of care increases. He said the proposed increases "are not sustainable" for individual consumers and small and medium-sized businesses.
Mais said a decision on the rates for next year would come by the end of the month.
Stephen Singer can be reached at [email protected].
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