CTattorneygeneral blasts health insurers for proposed rate hikes [Journal Inquirer, Manchester, Conn.]

Aug. 21--If approved, the price increases would affect health insurance plans sold commercially both off and on the Affordable Care Act exchange, with an average increase of 20.4 percent for next year. Small group plans would see an average 14.8 percent increase.

Pushback on the rate hikes came from a range of state officials and lawmakers at the hearing.

"We're here this morning because Cigna, Anthem and ConnectiCare want even more money," Tong said, speaking in person at the hearing in Hartford. "They want rate increases that will take millions more from Connecticut families."

The three insurers "have failed to justify rates that are excessive on their face and unsupported by the facts asserted in their applications," Tong added.

Health insurers countered that they are being squeezed by higher drug costs, expanding and consolidated hospital systems and a growing list of state mandates that impact costs.

New drugs like Ozempic, which costs about $1,000 a month per patient, could soon be key drivers in higher pharmacy costs, said Zach Moon, actuarial director at Cigna. Although not currently marketed for weight loss, drugs like Ozempic could balloon costs for insurers if made more widely available.

"[The drugs] are not explicitly included with our forward trend, but we do see risk there as they come to market later," Moon said.

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The expansion of hospital systems like Hartford HealthCare and Yale New Haven health also adds to costs by reducing insurers' bargaining power, said ConnectiCare President Mark Meador.

"The hospital systems' consolidation in our state has made it more difficult for us to negotiate reimbursement rates on behalf of our and our customers to achieve the state's cost growth benchmark," Meador said.

Meador joined other insurers in blaming the bulk of rising costs on the demands of hospitals and other providers. "Connecticut's health care providers need to be held accountable for increasing their charges, just as the state's insurance companies are being held accountable," he said. Hospital systems were also targeted for adding expensive services and new facilities, further inflating costs that are passed on to insurers and patients.

Legislative mandates on insurance coverage -- 64 and counting that go beyond national standards -- are also pushing up health care prices, said Brandon Rousseau, sales director at Anthem, the state's largest health insurer.

"While the cost of some mandated benefits in isolation may be relatively small, their collective impact drives up the cost of insurance coverage for every person in Connecticut," Rousseau said.

After they presented their case for higher rates, the insurers were blasted by Tong for alleged fuzzy math in calculating trends that could impact future costs and justify higher rates.

"What I ask the department to do today is to push back on that and reject these unjustified trends," Tong said. He also urged the companies to press hospitals and providers to justify costs for every service. "

"The insurers must be made and incentivized to negotiate costs and then negotiate down to hold providers accountable and to save money and provide better care and better service for the people of the state," he said.

Health costs in Connecticut are rising sharply despite recent efforts like the new health care price benchmark law signed last year. That bill was aimed at limiting price increases but the state's health costs still grew faster than any other benchmark state in recent years, said Deidre Gifford, executive director of the Office of Health Strategy.

The state saw an 18.8 percent increase in commercial health care spending growth in 2021 despite an increase in median income of only 1.9 percent.

Patients failed to get better care despite Connecticut's higher costs, Gifford added, displaying a chart that showed that the state's hospitals lag lower-cost states in the Northeast like Massachusetts and Rhode Island on quality measures.

"Our higher prices are not buying us higher quality than our neighboring states," Gifford said.

After intense criticism of hospital systems in the morning, the Connecticut Hospital Association issued a statement on the rate increases Monday afternoon.

"It will take everyone working together to slow the rate of health-care cost growth and we welcome other industry colleagues, including in the health insurance industry, to join in that work," CHA said in the statement. The industry group also pointed to "significant underpayment by Medicaid for healthcare services" as a driver of cost increases.

State Healthcare Advocate Ted Doolittle said he wanted to hear more from hospitals at hearings like Monday's on their role in driving up health costs in Connecticut. He also asked the insurers to publicly identify the state's highest-cost hospitals.

"You folks are here in some ways quite unfairly, as a stalking horse for the hospitals," Doolittle said to the insurance company representatives. "I believe that the hospitals should be here. We should identify which ones are contributing the most to the trend and they should be here every year."

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