CT GOP wants to know how many exchange customers were uninsured

Thursday is the deadline for the legislature’s Insurance and Real Estate Committee to move forward its proposals for this session. Among the measures still awaiting action is a controversial bill that would require the state’s health insurance exchange, Access Health CT, to report on the number of enrollees who were previously uninsured.

The proposal would require the exchange to provide legislators with monthly reports on enrollment, including the number of people enrolled in Medicaid and private insurance through the exchange, the number of people buying private insurance who are eligible for a federal subsidy to help cover their costs, and how many of those getting coverage were previously uninsured.

The extent to which the exchange is covering the uninsured or attracting customers who had other insurance plans in the past has been a sticking point for exchange critics, who say it’s a key indicator of whether the new marketplace is succeeding. Access Health officials say it's difficult to get the data that would show how many customers were previously uninsured and that the information they have is not entirely reliable.

“The people in our state need to know whether or not the exchange is working and is the success that they claim,” said Rep. Rob Sampson, R-Wolcott, the ranking House Republican on the committee.

The bill would also require more extensive background checks for people who work for or on behalf of the exchange, including people known as “assisters” and “navigators” who are tasked with spreading the word about coverage options and helping people sign up.

“These people have access to very, very private, personal information,” Sampson said. “It’s ripe for an opportunity for people that are involved in identity theft.”

But exchange CEO Kevin Counihan has said the requirements of the bill are unnecessary and would be costly to implement.

Counihan said the exchange’s current background check, used for all employees, navigators, assisters and vendors since last July, is comprehensive and takes about 48 hours, with a cost of $36 per person.

By contrast, the background checks the bill would require would include fingerprinting and would cost $50 per person and take more than two weeks, Counihan said.

As for the reporting requirements the bill proposes, Counihan said, fulfilling them would require spending more than $500,000 on system and reporting enhancements, and would require redirecting staff from work focused on customers. He noted that the exchange already fulfills the federal government’s reporting requirements.

In written testimony, Counihan said he understood the bill’s intent, but said it presented “an unneeded distraction” and would jeopardize Access Health’s “ability to continue to be a national leader in exchange implementation.”

The insurance committee has already advanced two other measures related to the exchange.

One bill would allow the exchange’s board to negotiate premiums with insurance companies beginning next year, a revised version of a proposal that would have required the board to negotiate premiums.

Supporters of the original bill, including Senate Majority Leader Martin Looney, D-New Haven, state Healthcare Advocate Victoria Veltri and consumer advocates, said negotiations could lead to lower premiums for plans sold through the exchange.

But the Connecticut Insurance Department, which reviews and approves rates for all plans sold on the exchange, considered the measure unnecessary. Business and insurance groups also opposed the proposal, saying that it could reduce competition in the exchange and compromise the insurance department’s role as a regulator.

The revised bill passed the committee 14 to 5.

A proposal that would add an insurance broker to the board that oversees the exchange cleared the committee unanimously. Brokers argued that the change would add professional expertise to the board, but consumer advocates warned that it would create a conflict of interest.

The composition of the exchange’s board has been a contentious matter since it was established, with advocates complaining that consumers are not adequately represented and that there are members -- some of whom have since left the board -- with industry ties. The Connecticut State Medical Society, meanwhile, urged lawmakers to add a practicing physician to the board.

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About Arielle Levin Becker

Arielle Levin Becker was a finalist in 2009 for the prestigious Livingston Award for Young Journalists, a recipient of a Knight Science Journalism Fellowship and the third-place winner in 2013 for an in-depth piece on home caretakers from the National Association of Health Journalists. Arielle previously worked for The Hartford Courant, most recently as its health reporter. She also has covered education and municipal beats for The Courant and for the Home News Tribune of East Brunswick, N.J. She is a 2004 graduate of Yale University. E-mail her at alevinbecker@ctmirror.org.

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