HARTFORD, CT.— Members of the Insurance and Real Estate Committee heard hours of testimony on two bills that would provide low-income state residents access to critical medical care including low-cost insulin and continued telehealth visits until June of 2021.
One in four Americans is rationing insulin – a dangerous practice that could lead to death – and the coronavirus pandemic has changed the way healthcare is delivered through audio telemedicine that can reach the poor who don’t have access to much technology, state Sen. Matthew Lesser, D-Middletown, said.
But industry representatives from the state’s six largest healthcare insurers are bucking both pieces of legislation on the grounds that they need further review and could create “unintended consequences.”
Kristen Whitney-Daniels was spending her entire income — $2,400 a month—on insulin until she was able to access a government program through a community health center. She now pays $14 a month. But Whitney-Daniels, the chapter director for #Insulin4all understands that there are scores of state residents who don’t qualify and who need help receiving the life-saving diabetes medication.
Whitney-Daniels testified seekding adjustments to LCO 3601, which would cap insulin costs at $25 a month for state-regulated insurance plans including Medicaid. At community health centers, it would cap the cost of insulin supplies and allow patients to receive an emergency 30-day supply of insulin without a prescription. The bill would save lives, she said. But it doesn’t go far enough to protect enough people.
“The cap only applies to 28 percent of residents,” she said. “There are 5.4 million Americas without health insurance right now.”
But it’s a start, said Danny Houdeshell, whose son, Kevin, died in early 2014. Kevin Houdeshell was well liked and respected by his co-workers at T.G.I Fridays in Ohio. To this day, his parents hear stories about their son’s kindness, he said.
Kevin Houdeshell ran out of insulin during the New Year holiday in 2014. His doctor was unavailable to write a prescription that would have allowed the 36-year-old to easily get his medication. Kevin thought he had the flu, his father told the committee by video as he was sitting in his car. What was actually happening was that his organs were shutting down due to the lack of insulin, Danny Houdeshell said.
“No person should die because he could not get a refill because his doctor was unavailable,” Danny Houdeshell said.
Connecticut would be the 20th state to pass some form of “Kevin’s Law,” named after Kevin Houdeshell, which allows a pharmacist to dispense an emergency supply of insulin without a current prescription, said Committee Co-chair Sean Scanlon, D-Guilford.
“Your son’s loss is not being forgotten in any way,” Scanlon said. “All of us are proud to have you speak today.”
The committee had begun work on the insulin bill before the coronavirus pandemic shut down the legislature. Lawmakers agreed to take up the bill and the telehealth bill during a special legislative session slated to start Thursday.
The Connecticut Association of Health Plans, which represents Aetna, Anthem, Cigna, ConnectiCare, Harvard Pilgrim and United Healthcare, opposes significant portions of the bill on the grounds that “capping copays, unfortunately doesn’t do anything to address the actual cost of the drugs and the supplies.”
“At the end of the day, we are always trying to make healthcare more affordable,” said Susan Halpin, executive director of the association.
There is a cost crisis, Halpin said. But, the association believes the focus should be on the underlying actual drug price charged not on the copays which, if capped, she said will only exacerbate the situation by removing any leverage health plans have to negotiate lower prices with the drug manufacturers.
The association also opposes LCO 3614, the bill that would extend telehealth services be reimbursed on a parity basis the same as in-person visits until June 30, 2021.
Halpin, executive director of the Association, noted that health insurance carriers have voluntarily extended provider payment parity since the inception of the pandemic, but that they disagree with the wisdom of codifying the provision in statute. Halpin, while agreeing that telehealth is a critical service, suggested that more data is needed to determine whether paying parity for telehealth is value added or has the unintended consequence of raising premiums.
Gov. Ned Lamont expanded telehealth services by executive order early in the pandemic. The bill would expand the types of medical services that patients can utilize and allow healthcare providers to receive the same fee for service for telehealth as in-person office visits beyond the executive order, which expires in September.
Telehealth during the pandemic has been key for underserved populations, said Mark Masselli, founder of Community Health Center, which provides low-cost health services to 130,000 residents statewide. “We should not let poverty be a barrier for patients,” Masselli said.
Low-income residents who do not have access to technology such as smartphones or tablets have been able to access treatment through audio telephone calls, he said. The West Coast has successfully used telehealth for years while in the Northeast, the service is in its infancy, Masselli said.
“We can’t lose this major innovation now, it would be disastrous,” Masselli said. He recommended that the legislature codify the use of telehealth in legislation.
Halpin, on the other hand, said that more data was needed to determine if telehealth was providing valuable medical services to patients and that relying on telehealth could have “unintended consequences.”
“Anecdotally there are positives and negatives,” Halpin said.
But Sen. Saud Anwar, D-South Windsor, a physician who has provided healthcare to coronavirus patients, questioned the association’s response to the telehealth legislation.
“One way to delay something is to say we need more data,” Anwar said. “The other way is to say there are unintended consequences.”