When confidence is broken… Promises not fulfilled cast a pall on Affordable Care Act

(The following op-ed from Sen. Kelly appeared in The Day on Dec. 8, 2013)

Peace of mind is what every citizen wants when it comes to health care. People want to know that their insurance is reliable, practical and here to stay. They want assurances they will be covered when sick, able to afford a consistent level of coverage for them and their families. Unfortunately, major national health care shifts make it nearly impossible to feel secure today.

In 2010, President Obama made a promise to the American people. His repeated promise, that individuals could keep their current insurance plans if they wanted, was a major concession that comforted lawmakers enough to allow passage of the Affordable Care Act (ACA). Today, we know this promise was false.

In an attempt to right his wrong, the president said he would allow insurers to revive policies that were cancelled for not meeting the requirements of the Affordable Care Act. Unfortunately, and surprisingly, Gov. Dannel P. Malloy chose not to follow the president’s recommendation in Connecticut, even though an estimated 75,000 Connecticut residents rely on policies that will be cancelled under the ACA. The president acknowledged a flaw in his plan, asked for more time to correct its problems, but Malloy said no.

The result is that thousands of individuals have not only lost their familiar insurance plans, but also their sense of confidence in the system. The mess created by the ACA is enough to rattle anyone; but can you imagine losing your insurance, then being told by the president that you might get it back, and then being denied the possibility by your governor? So much for, “If you like your plan, you can keep your plan.” Conflicting answers from our leaders are never reassuring.

Peace of mind has also been lost among senior citizens. While the governor and ACA proponents claim that Medicare in Connecticut will not be negatively impacted by the new law, we know this is false. Medicare Advantage, an alternative to traditional Medicare that is provided by a private insurer and covers about 21 percent of those enrolled in Medicare in Connecticut, was in fact impacted by the ACA. We saw this in the controversial actions of United Healthcare cutting doctors from their Medicare Advantage plans. While I am not in support of United Healthcare’s decisions, we have to acknowledge that the insurer is not solely responsible, and part of the blame for this falls on the ACA.

The act contains $205 billion in reductions to the Medicare Advantage program from 2013 to 2019 due to changes in reimbursement methodology. Facing these cuts, United Healthcare decided to cut their own costs by increasing premiums and cost-sharing for primary and specialist visits and reducing the size of their provider networks.

On Saturday seniors faced the latest deadline to apply for open enrollment in Medicare Advantage plans. They did so not knowing which doctors will be dropped from specific policies. People are selecting plans blindly, hoping that their current physicians will be covered. So much for, “If you like your doctor, you can keep your doctor.” This situation, caused by the new health care law, is unsettling and unacceptable.

If the unanticipated negative effects of ACA were not enough to unnerve you, the inability of Access Health CT to provide specific information about enrollment benchmarks should have us all worried. Every new program needs to be measured, tracked and analyzed so we can learn what is successful and what needs to improve. Over the past few weeks I realized that while numbers are being collected, there are no established goals to determine if Connecticut’s new system is actually going to prosper.

The only way Access Health CT will be financially successful is if a wide age range of people sign up for coverage, so that premiums paid by younger and healthier individuals will offset the costs of care for older and sicker individuals. Right now 19 percent of Access Health CT’s private insurance customers are between 18-34 years old, and 55 percent are over 45 years old. Last month, at an Insurance Committee meeting, Access Health CT could not provide a goal for the age ratios that would make this system work. These are benchmarks that we should know.

Looking at the basic principles on which the health care changes were built, I am not surprised that we see so many challenges. Those who designed the law believe government should make decisions for people related to health, including how much coverage they need and what price they should pay. I strongly disagree with a system that takes away people’s ability to make decisions. When we leave all the decisions up to the government, we lose individual control and freedom. When we see such a haphazard and flawed system unrolled by the federal government, we cannot help but lose our sense of confidence, security and peace of mind in national health care.

Kevin Kelly is a Republican representing the state’s 21st Senatorial District, which includes the towns of Monroe, Seymour, Shelton and Stratford. He is ranking member of the Insurance Committee and reachable at [email protected]