Finding the right balance between affordability and quality health care benefits meant recommending the ConnectiCare HMO plan as the “benchmark” package of benefits the Insurance Exchange Board should consider as it looks to adopt an “Essential Benefit Plan.”
A health care advisory board made that recommendation Wednesday to the Insurance Exchange Board, which under the Affordable Care Act must adopt a statewide benchmark package of benefits to be offered by plans on the exchange.
“We chose ConnectiCare because it has a marginally more robust benefit package than the Aetna or Anthem benchmark plans,” Jennifer Jaff, executive director of Advocacy for Patients with Chronic Illness, said.
Every state’s Essential Health Benefits, or EHB, package is required to provide emergency services, mental health services, hospitalization, prescription drugs, pediatric services, maternity care, and rehabilitation among other medical services.
“The worst thing we could do would be to end up with the richest plan out there and have it be completely unaffordable,” Anne Melissa Dowling, the deputy commissioner of the Insurance Department and co-chairwoman of the advisory committee, said.
She said the recommendations the advisory committee made Wednesday are consistent with Institute of Medicine guidelines and balances the “sometimes opposing goals of affordability and comprehensiveness of coverage.”
In June, the advisory committee eliminated the three Federal Employee plans as options for Connecticut’s benchmark because “they did not fully represent the Connecticut health mandates and the fiscal impact to Connecticut would have been higher than with any of the other plan options,” Dowling said.
The group discussed making sure elective abortion was covered by whatever plan they chose. None of the three Federal Employee plans cover elective abortion and the Affordable Care Act makes clear that no federal funds can go to abortion coverage, but the state can choose a plan that covers it.
“What’s in place in the state today is staying in place. There’s nothing we did that changed what’s currently going on in the state of Connecticut,” Dowling said. “We did nothing different than what was determined by legislation many years ago.”
Pro-Life advocate Nicole Peck argued that “real health care” helps people and though abortion may seem like a quick fix to a sticky situation, it’s not, she said.
“Abortion is simply not healthcare and it does not help women, or families, or our future legacy as a state or country,” Peck told the advisory committee before they made their decision Wednesday.
After the meeting, Michael Culhane, executive director of the Connecticut Catholic Conference, declined to comment on the board’s recommendation. He said he prefers to wait until he receives a response to a letter he sent the new Insurance Exchange CEO Kevin Counihan regarding restrictions for abortion funding.
The advisory committee also selected the Connecticut Health Insurance Program as the state’s dental plan, the Oxford Plan for a prescription drug plan, and the Federal Employees Vision plan to recommend to the Exchange Board.
The Insurance Exchange Board is expected to receive the recommendations at its July 26 meeting and plans to adopt an essential benefit plan later this summer.
In 2014, Connecticut residents will, under the Affordable Care Act, be required to buy their insurance through the exchange. The exchange will feature a web portal and each of the plans offered through it will have to cover the essential benefits adopted by the Insurance Exchange Board.