Health care forum addresses concerns
The Affordable Care Act, more commonly known as Obamacare, has confounded people who don’t know what their options are.
With that in mind, state Rep. Gail Lavielle (R-143) and state Sen. Toni Boucher (R-26) gathered a collection of health care experts in the Brubeck Room at Wilton Library on Thursday, Nov. 14. The open forum allowed residents to pose questions regarding the Affordable Care Act and the Connecticut Healthcare Exchange.
“Every day I hear from constituents who are confronting new, unexpected situations due to the new federal law,” Ms. Lavielle said. “Many have had their health insurance policies canceled, and others can no longer see their doctors under their plans.”
“I am very concerned that the new federal law adversely affects our residents,” Ms. Boucher said. “Many people are losing the doctors they have built a lifelong relationship with.”
The panel included a collection of experts, including Demian Fontanella, general counsel of the Office of the Healthcare Advocate. John Lavin is the owner of Beacon Physician Placement Services, with 20 years of medical practice management experience. Also on the panel was Peter Van Loon, chief operating officer of Access Health CT, George Watts, employee benefits adviser with Health Consultants Group, and Dr. Michael Hunt, chief medical officer of St. Vincent’s Health Partners Inc.
Kevin Murray, who runs an insurance agency in Bethel, sat in the front row of the audience and was a contributor to the discussion as well.
Among the myriad topics addressed was terminology, family impact, and the new health exchange.
The exchange — the marketplace known as Access Health CT — is a key component of President Obama’s health care law. Recently released demographic information indicates that 54% of 12,648 individuals enrolled with private insurance plans and Medicaid are between 45 and 64 years old.
“I think you have to be consumers of health care to really begin to understand how what you’re used to getting is going to change,” Dr. Hunt said. “I don’t mean that in a negative way. I really mean that in a way that says we want to start taking care of patients with quality. We really want to focus on every single patient and make sure they’re getting the right care at the right time.”
A concern for many has been letters received by those who buy their own private insurance. While roughly 15 million people do get their own insurance on the private market, roughly half of them have received cancellation notices.
“The law said policies must meet a certain level of coverage, both in terms of financial and clinical coverage,” Mr. Van Loon said. “There are a lot of plans out there that have too high of a deductible or they don’t cover pregnancy,” for instance.
“If you want to check out your options, you can come on our site (Access Health CT), but please don’t think that that’s the only avenue. We have lots of people out there — brokers — that can help, too.”
Dr. Watts advised people to review individual carriers who are directly selling insurance.
“We don’t have all of the carriers on the exchange,” Mr. Van Loon said.
In fact, after being asked by Ms. Boucher, he added that the exchange has Healthy CT, ConnectiCare, and Anthem health care on the exchange.
One word constantly being passed around the room was research.
“I think one of the things that people are finding very daunting is the very act of doing the research,” Ms. Lavielle said. “There is so much research that can be done and so many places that are available to go. It’s hard to know which is right and which is the best expense of your time. I think the answer that people are looking for is where is the central place that I can go that someone can sort this out for me and tell me reasonably what I can sit down and look at, compare and decide with.”
The consensus from the panel was that carrier websites offer a lot of information.
“I would start there,” Dr. Watts said. “It’s probably best to stay with the individual carrier websites and start there.”
Mr. Van Loon added that all carriers are required to have a brief but more detailed plan summary document, and he felt that everyone should start there.
“It’s required by the Affordable Care Act,” he said, in reference to the document.
“The devil is in the details. Especially when it comes to some of the more specialty care, more specific medical needs.”
“If we don’t have an educated consumer, we will have a frustrated consumer,” Mr. Fontanella added.
In Connecticut there are six “navigator” agencies and navigator-certified insurance brokers to help consumers make decisions about a plan. Enrollment help over the phone from an in-person assister is available by calling 1-855-805-HEALTH (4325).
Both Ms. Boucher and Ms. Lavielle offered their concern about how overwhelmed consumers — prospective patients — are.
“Getting return phone calls from health care operators is still an issue,” Ms. Boucher said. “It is clear there is much that still needs to be resolved at the federal level, and constituents will continue to have problems. We will continue to seek answers to these questions and share the information with residents as it becomes available.”
“We will do everything we can to help them navigate what has become a very complex system,” Ms. Lavielle said.