Many consumers who obtain insurance through Connecticut’s health care exchange don’t understand the plans they buy—and can struggle to access care as a result, according to a new report. Insurance plans typically use complicated language that is difficult to understand, according to the Health Disparities Institute, UConn Health. As a result, some patients have trouble accessing care, experience delays in care, encounter administrative hassles and face other hurdles, the study found. The institute conducted a statewide poll last year among 516 adults who enrolled in qualified health plans through Access Health CT (AHCT), the state health insurance exchange created under the Affordable Care Act. Many struggled to understand basic insurance terms like “premium,” “deductible” and “co-pay.”
More needs to be done to educate all health insurance consumers, regardless of where they buy their policies, said Lisa Freeman, executive director of the nonprofit Connecticut Center for Patient Safety.
Consumers can begin shopping for 2017 health insurance through Access Health CT (AHCT) starting Nov. 1, but they will encounter fewer options and steeper prices than in previous years. Now in its fourth year, the state’s health insurance marketplace looks different than it has in the past. Most notably, it has only two insurance carriers, ConnectiCare and Anthem, instead of four. State insurance regulators approved a 17.4 percent increase in ConnectiCare’s rates for exchange plans and approved a 22.4 percent rate hike for Anthem’s plans.
As we open the book on 2016, here are a few things to watch for in the field of women’s health and well-being. In no particular order, from the Office of Healthcare Prognostication—a department I just made up—comes these predictions for the new year:
1 • The use of mobile health apps, or so-called “health wearables,” will increase, according to the American College of Sports Medicine’s 10th annual survey on fitness trends. Already, the adoption of smartphone health apps has doubled in the last two years, from 16 percent in 2013 to 32 percent of consumers saying they have at least one health app on their mobile device. 2 • Beyond measuring one’s fitness, health care in general will begin a “shift into the palms of consumers’ hands,” according to PwC’s 2015 Health Research Institute’s annual report. It’s happening already in primary care and the management of some chronic diseases, though programs such as Omada Health’s online program called Prevent are pushing into fields such as behavior modification.
Open enrollment for consumers to buy health insurance through the Access Health CT marketplace begins Sunday, and 2016 will bring considerably steeper fines for consumers who lack insurance. Access Health CT (AHCT), now in its third year, enrolled close to 100,000 individuals in private insurance plans in its first two years, according to Andrea Ravitz, director of marketing. About 500,000 enrolled in Medicaid through AHCT, during the first two years. The marketplace aims to enroll between 105,000 and 115,000 in private plans by the end of open enrollment, Ravitz said. AHCT concentrated on attracting new enrollees its first two years but this year it has been focusing on retaining enrollees, she added.
Women in Connecticut have been denied health insurance benefits in violation of the federal Affordable Care Act, according to a study by the National Women’s Law Center. Connecticut is one of 15 states included in the study, which analyzed the 2014 and 2015 health plans of companies that provide coverage under the ACA in state marketplaces. It found violations in all 15 states and concluded that they are likely occurring nationwide. According to the report, Connecticut women have been denied coverage for the following: breastfeeding counseling and education after two months following delivery, infertility treatments after the age of 40, sterilization procedures, emergency birth control, and maintenance care for such things as lupus, HIV, and hormones after breast cancer treatment. Coverage was also denied for transgender transitions.
Tens of thousands of Connecticut residents who receive federal subsidies to help pay for health insurance won’t be affected immediately by the latest challenge to the Affordable Care Act before the U.S. Supreme Court. But experts say there’s a good chance Connecticut residents will experience some political fallout from the court decision – which could come as soon as Thursday – challenging the validity of federal premium tax credits to 6.4 million Americans in 34 states with federally operated insurance marketplaces (also known as exchanges). Nearly 74 percent (74,682) of the 101,294 people who purchased commercial health insurance plans through Access Health CT (AHCT) received federal subsidies, as of June 2015. Connecticut is among the 16 states – along with the District of Columbia – that established their own state-based marketplaces through the health law. A court decision that blocks health insurance subsidies in the federally-operated marketplaces could lead to “some crazy maneuvering at the federal level from a legislative perspective that could impact Connecticut” if Congress moves to repeal or significantly modify the law, said James Wadleigh, chief executive officer of AHCT.
Connecticut consumers who carefully consider their health status and financial needs stand to reap the greatest benefits when shopping for insurance during the 2015 open enrollment period. The enrollment period to purchase coverage at Access Health CT (AHCT), the online marketplace created by the Affordable Care Act, runs from Nov. 15, 2014, to Feb. 15, 2015. The law requires most Americans to carry health insurance or pay a fine when they file their federal income taxes.