HARTFORD, CT — Everything is on the table when it comes to navigating how Connecticut will move forward if Congress is able to make changes to the Affordable Care Act.
Lt. Gov. Nancy Wyman, who has chaired the Access Health CT board of directors since the inception of state exchanges, said “we’re looking at all different areas.”
A state-based individual mandate, a Medicaid for all plan, and a reinsurance program are just some of the options Wyman is investigating with Democratic and Republican lawmakers and exchange officials.
She said at this point they are just gathering information so they can be prepared to take action regardless of what happens in Washington.
At the moment Connecticut is looking at what other states are doing.
The Nevada legislature just sent a “Medicaid-for-all” measure to their governor. Under the proposal, Medicaid coverage would be offered alongside commercial insurance on Nevada’s state-run health exchange starting in 2019.
New York is having discussions about a single-payer system, according to Jim Wadleigh, CEO of Access Health CT. The price tag of similar proposals contributed to the defeat of similar legislation in other states.
In Minnesota, they are looking at using a waiver from the federal government to create a reinsurance program, Wadleigh said. Last month the Minnesota legislature passed a $542 million reinsurance program aimed at limiting future health insurance rate spikes. It would reimburse health insurance companies for certain high-cost claims.
Connecticut’s General Assembly didn’t pass any legislation before June 7 that would change how health insurance in the private market currently operates.
The U.S. Senate is expected to vote on a proposal to replace parts of the Affordable Care Act before the July 4 recess. Any action, or lack of action, will impact how Connecticut plans for 2019.
Wadleigh presented three scenarios to the board Thursday.
The first assumes that the exchange continues with two insurance carriers. However, the enrollment period would be shortened to six weeks and the two store fronts in New Britain and New Haven would close. The second scenario assumes one carrier left on the exchange, which means staff would have to work to transition all the customers from the departing carrier. The third scenario assumes no carriers participate and the exchange would help transition all consumers into the private individual health insurance market.
Board members scoffed at the shortened enrollment period, but Wadleigh said that’s what the carriers have requested because of the premium payment stability it gives them.
He said they won’t really know which scenario they will be faced with until April or May of 2019, when the insurance carriers submit their rates to the Insurance Department for review.
The Insurance Department is currently reviewing the 2018 double-digit rate increases proposed by Anthem Health Plans and ConnectiCare Benefits, the two remaining insurance carriers on Connecticut’s exchange. Both carriers have said they reserve the right to modify their rates if Congress eliminates the cost-sharing reductions or tax credits.