Governor Lamont Proposes Laws To Scale back Well being Care Prices
(HARTFORD, CT) – Governor Ned Lamont as we speak held a information convention in New Britain to introduced that he has submitted multi-pronged legislative proposals to the Basic Meeting that concentrate on decreasing well being care prices for Connecticut residents, with a selected emphasis on enhancing competitors, eliminating pointless costs, decreasing rising costs, and rising affordability for residents and employers.
The laws is Home Invoice 6669, An Act Defending Sufferers and Prohibiting Pointless Well being Care Prices, and Senate Invoice 983, An Act Limiting Anticompetitive Well being Care Practices.
“Gallup not too long ago reported that record-high numbers of Individuals are pushing aside care because of prices,” Governor Lamont stated. “Roughly 38% of Individuals delay care in 2022, the very best proportion Gallup has ever seen in its 22 years of polling. Two-thirds of private bankruptcies are associated to medical debt, the commonest reason behind chapter, and healthcare is consuming a bigger and bigger proportion of GDP, now greater than 18%. We merely can now not afford to not take motion. These payments I’m proposing deal with this advanced drawback from a number of angles, and I’m calling on all events – insurers, hospitals, docs, employers, and customers – to affix with me in engaged on options for the individuals of Connecticut.”
“Entry to reasonably priced and high quality well being care is certainly one of most necessary points dealing with Connecticut households and companies at a time when prices are rising and insurance coverage covers lower than it used to,” Comptroller Sean Scanlon stated. “The struggle for higher well being take care of the individuals of this state is certainly one of my largest priorities as comptroller, and I’m proud to be working with Governor Lamont to move a ‘sufferers first’ well being care reform agenda that may decrease prices and guarantee everybody has entry to the care they deserve.”
“Whereas our state’s well being care system is excessive in high quality and ranks among the many greatest nationwide, the rising prices stay a barrier for much too many individuals and leads to many individuals pushing aside care as a result of they will’t afford it,” Dr. Deidre Gifford, govt director of the Connecticut Workplace of Well being Technique, stated. “It’s clear that hospital inpatient, hospital outpatient, and retail pharmacy prices are the biggest contributors to the well being care affordability drawback. Well being system consolidation and lack of competitors can also be contributing. These multi-pronged proposals tackle main price drivers in these areas and develop on our persevering with efforts to include medical prices.”
“The price of well being care is a problem for almost everybody within the state, however it’s significantly acute for individuals of coloration,” Tiffany Donelson, president and CEO of the Connecticut Well being Basis and member of the Workplace of Well being Technique’s Healthcare Benchmark Initiative Steering Committee, stated. “Information from the Connecticut Healthcare Affordability Index present that individuals of coloration are particularly more likely to have well being care prices which can be unaffordable – that’s, their well being care prices are too excessive to fulfill different primary wants with out going into debt. The results of unaffordable well being care are clear and troubling: individuals skipping medicine, avoiding care, and family budgets stretched to the breaking level to repay medical debt. We can not obtain well being fairness until well being care is reasonably priced. The causes of excessive well being care prices are advanced, however the want is easy – we should all work collectively to guarantee that everybody can afford to get the care they want after they want it.”
- Eliminates hospital facility charges charged at free-standing places of work and clinics.
- Implements stronger regulatory enforcement instruments on the Connecticut Workplace of Well being Technique to guarantee compliance with certificates of want necessities and associated circumstances of approval, resembling price controls, affected person entry, and detailed reporting. This may curb well being care prices by stopping duplicative providers in particular areas, whereas making certain availability and entry to important providers in all components of the state.
- Commits Connecticut to becoming a member of a multistate bulk buying consortium to barter prescription drug reductions that all the state’s residents will have the ability to entry by way of a reduction card at their pharmacy.
- Requires the Connecticut Workplace of Well being Technique to yearly publish a listing of pharmaceuticals which can be experiencing main worth spikes to tell customers and prescribers about which drug costs are going up and by how a lot.
- Reins in aggressive advertising and marketing practices by pharmaceutical representatives to make sure prescribers get clear and correct details about the medication they prescribe and generic alternate options. Pharmaceutical representatives might be required to finish a coaching, register with the state, and disclose related details about drug prices and efficacy throughout totally different races and ethnicity, if identified.
- Strengthens protections to make sure that discounted pharmaceuticals bought by way of the federal 340B program profit the low-income customers and communities this system was designed to assist.
- Prevents worth gouging when sufferers get care from a supplier who will not be of their community. Particularly, the governor is proposing to restrict out-of-network prices for inpatient and outpatient hospital providers to 100% of the Medicare charge for a similar service in the identical geographic space.
- Outlaws using anti-competitive contracting practices which were utilized by well being programs to impede competitors and enhance costs. This may present well being insurers with further bargaining energy to make it simpler to barter reasonably priced costs for customers. These embody:
- Anti-tiering clauses: Requiring a well being plan to increase a most popular worth tier standing to all services or supplier in a well being system, even when sure suppliers don’t meet price or high quality requirements for that tier.
- Anti-steering clauses: Prohibiting insurers from utilizing incentives to steer sufferers to increased worth suppliers.
- All-or-nothing clauses: Requiring well being plans to just accept all suppliers in a healthcare system or none of them.
- Gag clauses: Stopping events from disclosing related info, together with worth or phrases of an settlement to a 3rd social gathering.
Home Invoice 6669 has been referred to the Public Well being Committee, and Senate Invoice 983 has been referred to the Insurance coverage and Actual Property Committee.
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