Thursday, July 26, 2012

A Big Day for Connecticut

The essential health benefit package (EHB) is going to be the blueprint for all individual and small group insurance starting January 2014 -- the package of benefits that must be covered.  Two advisory committees to the Exchange Board here in Connecticut have studied the issue, and today, our recommendations will be reported to the Board.  We worked very hard on this, spending months pouring over data, trying to choose a benefit package that balances affordability with comprehensiveness.  For months, we've been told that our recommendation would go to the Board, then the Board would make a recommendation to the Governor, and the state's final decision would then be communicated to the federal government.  Since both advisory committees chose the same compromise, you'd have thought that would carry a lot of weight with the Board.  However, it appears that the rules of the game are changing, that when we were told we had no more time and no more information, in fact, there was time for a 30 day comment period -- something nobody ever said was going to happen.  Is this just a nod to democracy, or is this a pretext for rejecting the advisory committees' recommendations, substituting them for a more restrictive suite of benefits?  I have a bad feeling about this.  Add to that the expectation that the anti-abortion Family Institute of Connecticut is planning to turn out in force to protest against insurance coverage of abortion, and this promises to be a red letter day.  Ugh.

UPDATE:  The Exchange Board has taken the matter of the EHB under advisement, with a vote expected at their August meeting.  The 30 day comment period  is for approval of the PROCESS for selecting an EHB.  Board members did ask about cost data, and one Board member in particular was concerned about selecting a plan that includes all statutory coverage mandates.  However, as was explained, those statutory mandates can only be changed by the General Assembly.  There were some anti-choice folks in the audience, but only one gave public comment.  So all in all, it was a less eventful meeting than anticipated -- and that's a really GOOD thing! 

Meanwhile, here's proof of the harm that will be done by states that refuse the Medicaid expansion.  Medicaid eligibility lowers the death rate.  Give more people access to health care and you save lives -- plain and simple.  And so if you withhold a Medicaid expansion that costs the state nothing in the first few years, and never goes below 90% federal funding, you are sentencing some people to death.  Nothing short of a life and death choice.

Minorities may have more to gain from health reform.  Higher rates of uninsurance is fertile ground for a huge advance when affordable insurance is available to all.

But here's a great step forward -- the federal government and private insurers are going to team up to put a dent in health care fraud.  By sharing and comparing claims data, they can find patterns of fraud and waste -- and bring in huge savings.  About time.

A group of doctors have filed a citizens petition with the FDA asking for new rules for prescribing pain meds.  We've all read about the overdoses and the selling of prescription drugs on the street.  But these sorts of restrictions have threatened the health and well-being of millions of patients with chronic pain.  There has to be a balance.

Do we in America use too much health care?  If so, is it driven by a medical system that profits off of over-use of its services?  Or is it driven by patients who hear about the latest and greatest treatment and can't wait to get their hands on it?  Tough but important questions.

If you have insurance, you're less likely to have advanced stage surgical cancer than if you're uninsured.  You still think health reform's goal of universal coverage is folly?

Can we cure HIV?  Scientists who gathered in Washington DC this week believe we are on the way.  I love the thought that, some day, we'll think back on the dark days of HIV/AIDS knowing that nobody will ever have to suffer with this awful disease again.

Do you talk about your illness?  Here are some thoughts on whether to tell or not.  As you know, I have always talked about mine, thinking that I could raise awareness and make it less scary for others to talk about their illnesses.  But it's important to be clear on what you're hoping for from others if you do tell.

There you go.  Stay tuned for an update on what happens in Connecticut today.  Since we're one of the states that's moving along on health reform implementation, what happens here today may affect what happens elsewhere.  So let's hope the powers that be for once resist the temptation to tinker with a democratic process to obtain the outcome they want.  Jennifer

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