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ELLEN ANDREWS

I couldn’t agree more with my advocacy friends who called on the legislature to open public hearings to online participation. The current process for legislative hearings is broken, almost requiring paid lobbyists to navigate. This excludes real-world input that is critical to successful policymaking. But legislative hearings are only part of the problem.

Connecticut policymakers need to abolish all task forces, boards, workgroups, design groups, consortia, advisory and steering committees, teams, councils, and similar committees. These insular groups, run with little transparency, are making big decisions that affect our lives without any public accountability. It’s not just a healthcare problem. An administration staffer noticed that every committee seems to have the same small group of lobbyists, their clients, and agency representatives. Not surprisingly, these echo chambers keep giving us very similar, deeply flawed proposals from each iteration.

A disclaimer: I’ve been on over a dozen of these Connecticut committees in my 25 years of consumer advocacy. I’m still an active participant on a couple now. I can see from the inside how broken they are.

Potential committee members usually have to know someone to get appointed. It used to be that committee members were appointed by several bipartisan legislative leaders, so there was a chance that an independent voice with a different perspective might be at the table. But the last two administrations have increasingly moved to one policymaker appointing all members. Applicants are disqualified if they won’t commit to codifying the already-determined plan. Divergent perspectives are then forced into public venues, which prompts anger and defensiveness from the sponsors. This is never a good way to make good policy.

Committee processes are very hard to track. Committee meetings about selling state residents’ medical data and capping Connecticut per-person healthcare costs are rushing ahead despite the global pandemic when healthcare stakeholders are overwhelmed.

Meeting agendas and materials are posted on obscure websites and are late or incomplete. Despite a Freedom of Information request, advocates were sent the wrong link to a recent online meeting. The materials from that meeting are still not online weeks later.

Qualifications have never been a condition of membership on committees. In one recent meeting, a couple of members acknowledged that they are not experts on the topic and were uncomfortable voting. It’s likely they weren’t alone.

While industries and agencies are typically represented by the usual suspects, consumers are often represented by someone very new to policymaking. Sponsors like having a continuous rotation of fresh, new consumer faces from the real world. However, by the time the new members get a sense of how things work, do some research, and start speaking up, they are quickly rotated off for newbies.

Another time-tested strategy to marginalize diverse voices is to create an entire committee for them and then ignore it. Last year, half of the members of the Consumer Advisory Board (now a Council), which was to advise the state on healthcare reforms, resigned en masse because their input was ignored for years.

Sponsors of these state committees will point to disagreements among the conflicted interests in committee meetings as proof that different viewpoints are represented. But contention between big insurers and large health systems does not prove that either is looking out for consumers.

A better process would be inclusive, accessible and transparent to all. Getting every interested voice engaged in common goals is the only way to make lasting change happen.

There are better models. The provisions in the advocates’ letter to legislative leaders are a great place to start, including online hearings and sign-ups, accessible technology, recordings of meetings, written or video testimony, timely sharing of proposals, sufficient notice of meetings, and full public access to all documents and materials.

The federal government publishes all proposed regulations, solicits comments online, and then publishes a response to all the points made. The entire process is public and easy to find. In addition to the public, experts and critical stakeholder groups could be invited, but not paid, to submit feedback on proposals, easing any conflict-of-interest concerns.

Connecticut needs to throw out the old, failed playbook for policymaking. Engaging independent voices and transparency are our only hope to make progress.



Ellen Andrews, PhD, is the executive director of the CT Health Policy Project. Follow her on Twitter @CTHealthNotes.

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