Steep hikes proposed for some health insurance plans in state

With some Connecticut residents facing health insurance increases of 20 percent or more, only a few took the opportunity on Tuesday to demand a change — though legislators and other advocates lambasted health insurers for raising rates during the COVID pandemic while pocketing billions of dollars in profits.

The Connecticut Insurance Department took testimony on Tuesday in advance of setting rates for 11 health insurers covering nearly 223,000 people.

About half of those people purchase insurance on their own dime through Access Health CT plans offered by Anthem Blue Cross & Blue Shield and ConnectiCare under the Affordable Care Act.

Many of Connecticut’s largest employers underwrite their own health plans, using insurance companies only on an outsourced basis for wellness programs and claims administration. Rates for those self-insured plans are not subject to approval of the Connecticut Insurance Department, which sets prices after a review of revenue, costs and actuarial assumptions by underwriters.

In Tuesday’s hearing, Easton resident Dan Pflug told the Connecticut Insurance Department he is paying nearly $34,000 for an Anthem policy covering his family, with company seeking a 12 percent increase for 2022. He said his plan has additional $2,500 deductibles for each family member that he must pay prior to any reimbursements on care.

“You guys have the power to stop this freight train,” Pflug said Tuesday. “What’s the point of approving premiums every year when there are no Connecticut citizens left who can afford to buy insurance?”

If plans are approved according to insurer requests, individual rates would rise anywhere from 1.1 percent to 22.6 percent, depending on the plan. Small-business plans would increase between 2.8 percent and 23.6 percent.

In advance of Tuesday’s hearing, the public had a 30-day window ending in mid-August to file written statements on the proposed plans. The Connecticut Insurance Department plans to issue final rulings in September, in advance of open enrollment for 2022 coverage starting Nov. 1.

State Sen. Saud Anwar, D-South Windsor, said the hikes outstrip annual income gains for many people, particularly those living paycheck to paycheck.

“The last year-and-a-half has been a nightmare for the average citizen in our state and for most businesses,” Anwar said Tuesday. “Some of these [insurers] have had billions of dollars in profits as people in our communities have been dying.”

An actuary with Point32Health — the successor carrier to Harvard Pilgrim Health Care after its merger with Tufts Health Plan — said drug costs are driving the increases.

“We are seeing a significant utilization trend on the pharmacy side, driven by high-cost drugs,” said Besart Stavileci, actuarial lead for Point32Health. “That’s what’s been driving our overall trend — and quite significantly.”

Sen. Tony Hwang, RFairfield, advocated alternative approaches to control costs like a price benchmark system that is used in Massachusetts where Point32Health is based, or avoiding pharmaceutical distributors altogether by creating a system to import lower-price drugs from Canada.

“The cost growth is out of control and insurance premiums are often the size of a monthly mortgage payment,” Hwang said. “It isn’t just this rate increase — it is the cumulative increase over ... [years] that has exceeded the affordability and the sustainability of families and businesses.”

A ConnectiCare actuary said his company’s average increase is in line with the cost increases being passed to it by physicians, hospitals, drug companies and other health services and product companies.

In addition to the accustomed inflation in drug prices and other costs, carriers are bracing for increasing clinic visits as a result of people having held off going to see doctors during the COVID-19 pandemic, and increases in “behavioral health disease” in the words of the Connecticut Insurance Department.

On average, rates for all 11 individual health plans under review would increase 8.6 percent, an increase from the 6.3 percent increase this year. Smallbusiness plans would increase 12.9 percent on average, on the heels of an 11.3 percent increase this year.

Ted Doolittle, Connecticut’s health care advocate, warned that runaway deductibles represent an additional expense that the department needs to factor into final rates.

“The process that we’re engaged [in] is really one of the only tools that Connecticut families have to be heard,” Doolittle said. “We’ve seen the [rate] trends go up like a trek up Mt. Kilimanjaro — and the health insurance industry has not been able to deliver ... competitive health prices to the families of Connecticut. ‘Why’ is a complicated question.”