Thursday, August 25, 2011

Connecticut Screwed Patients With Chronic Diseases Yesterday

Yesterday, the state of Connecticut made news on the new healthcare law that requires states to create exchanges where insurance plans can be purchased when the requirement to buy healthcare insurance goes into effect in 2014. But the reason the state made news is not for a good reason: the State of Connecticut effectively screwed its residents by ignoring a requirement in the Federal laws that requires that there be a CONSUMER REPRESENTATIVE on the Connecticut insusrance exchange. Insurance exchanges must be in states which have not opted out of the law (and that includes Connecticut) established to offer state-regulated and standardized health care plans, from which individuals may purchase health insurance plans that are eligible for Federal subsidies when they required by Federal law to do so in 2014. The exchanges are the quasi-public authority that govern these insurance exchanges.

Let me go on record as saying that Connecticut is no red state. To cite a rather vivid example: same sex marriage has been legal in Connecticut since 2009, and there were never protests of angry citizens marching in the streets arguing to stop it. In fact, after the courts determined that prohibiting same sex couples in Connecticut from receiving a marriage license was a blatant violation of the state Constitution's guarantee of equal protection under the law (the judge wrote "The Connecticut Constitution requires that there be equal protection and due process of law, not that there be equivalent nomenclature for such protection and process"). After that, the only legislative debate that really occurred was over a rule which exempted churches and other religious institutions from being required to facilitate same-sex marriages (the State does not require religious institutions to perform same-sex marriages, but a Town Clerk may not legally deny a same sex couple a marriage license because of his or her personal religious beliefs since they are civil servants on local government payrolls, they are NOT workers for private religious institutions, hence they are not permitted to let their personal beliefs interfere with doing their jobs). Socially, the state (which is sandwiched between New York, Massachusetts and Rhode Island) is of the "live and let live" persuasion; which means keep your nose out of our personal business, and you can expect the same courtesy in exchange.

A majority of citizens in Connecticut voted for President Obama, and surveys also show overwhelming support in the state for the The Patient Protection and Affordable Care Act (PPACA) which became law last year. Yesterday, the list of members of the Board of the Exchange for the State of Connecticut were revealed (see HERE), and many people with chronic illnesses in Connecticut were justfiably p!$$ed off. The reason: there is NOT ONE single consumer representative is on the exchange right now -- not one, yet Federal law actually requires that a consumer representative be on the exchange board. As Connecticut lawmakers selected the exchange members, they staffed the board exclusively with people who either work for the health insurance industry (the state being home to giants like Aetna make them plentiful), state government or other industries like hospitals that profit from providing healthcare.

Yet the federal Exchange regulations say, in the preamble, as follows: "Exchanges are intended to support consumers, including small businesses, and as such, the majority of the voting members of governing boards should be individuals who represent their interests." 76 Fed. Reg. 41872 (7/15/2011).

As a prominent blogger who writes the blog "Advocacy for Patients with Chronic Diseases" (she happens to be a patient with Crohn's disease and gastroparesis, and is also a lawyer more than 25 years) and is based in Farmington, Connecticut (near the state capitol Hartford) eloquently WROTE:

"I don't know about you, but that surely reads to me as though there should be -- oh, I don't know, maybe ONE consumer representative on the Board? Maybe one public official could have appointed someone who would join Vicki Veltri in expressing the consumer point of view?"

In fact, all of the 14 individuals selected for the Board are either members of Governor's administration, former insurance company executives, or individuals with political connections, but none, aside from the non-voting state Healthcare Advocate, are consumer advocates.

What does this mean?

Well, think about it. The Board is made up of government workers and insurance people, so how likely is it that the state's insurance exchange is going to represent the interests of PATIENTS, rather than the insurance industry? Do you trust a former Aetna executive to make choices that represent the interests of patients, or of the industry they have so many personal connections with? The Board also determines how the providers in the exchange are selected, what criteria will be used for selection, etc.

All of this certainly seems like an invitation for a lawsuit, doesn't it? In the meantime, if you live in Connecticut and a actually have chronic illness like say, diabetes, you might consider calling your state lawmakers and giving them an earful about finding ONE patient representative on this board. To find your local state government representatives, visit

1 comment:

Jenny said...

Connecticut's legislators are 100% owned by the insurance companies and the state has always been a nightmare for anyone who didn't have corporate insurance who had to deal with any kind of illness.

My advice for anyone with a chronic illness living in Central CT is to move to Western Massachusetts where insurance is available to everyone right now, without any screening for pre-existing conditions, and where insurers actually pay for what the contracts say they should.

In CT, insurers get away with terrible abuses--which I learned the hard way before I followed my own advice.