As Executive Director of the CT Legal Rights Project, an advocate for people with disabilities, and someone who identifies as disabled, I take issue with “Flaws in CT’s healthcare system must be identified to be corrected” describing the Office of Health Strategy’s (OHS) plan to limit healthcare cost increases. I couldn’t agree more that healthcare costs in Connecticut are too high. Consumers know this better than anyone as we suffer the denials of essential care and sacrifice other family needs to pay the bills. Consumers pay healthcare bills, directly through our insurance premiums, co-pays and deductibles, but also through higher taxes and lower wages. Additional investigation and reporting on what’s driving those costs wouldn’t hurt.
I recently resigned from the stakeholder advisory board of this cost growth benchmark project. [See my letter.]
Something this important should not be occurring during a pandemic. When Gov. Ned Lamont signed Executive Order No. 5 on January 22, the world had not yet changed. In these extraordinary times, Connecticut’s healthcare system is under massive pressure simultaneously caring for people suffering from COVID and getting primary preventive care to everyone else.
This year spending on care for COVID patients is enormous but spending on preventive and elective care is down sharply. Using 2020 as a benchmark year to set healthcare spending caps for the future is not sensible. To the extent decisions to impose a cost cap, and to use this as the base year, were previously decided, those decisions should be reconsidered.
People with disabilities often need more healthcare than other Connecticut residents putting us at special risk under the cost cap. COVID has highlighted disturbing disparities in health and healthcare for people of color in our state; this cost cap could make a bad situation worse. There is no plan to monitor harm to people with disabilities caused by the cap. Even reporting on the quality of care in Connecticut won’t happen for at least a year after the cost cap is implemented. But cutting costs by compromising quality in times like this should be avoided.
As an advocate for individuals with disabilities, I am even more concerned about the proposed plan to ultimately enforce a cap when the benchmark is exceeded. It appears that OHS plans to enter into confidential negotiations with plans or health systems that exceed the cap to bring their costs down. The resulting agreement could result in reduced access to less profitable care, such as mental health and substance-use treatment. This would benefit the health system and health plans, by raising profits, while lowering total costs under OHS’s cap, but patients who need this care would suffer. Policymaking this important should be done in full public view with input from all of the communities and stakeholders directly affected.
Connecticut needs to address rising healthcare costs, for all the reasons given by OHS. More detail on spending could help. But we must not risk sacrificing the health of state residents, especially those who need healthcare the most, pursuing a project developed in a pre-COVID world.
Kathleen M. Flaherty is Executive Director of the Connecticut Legal Rights Project, Inc.