Lawmakers look to lower healthcare and insurance costs

Senate Democrats have unveiled two bills aimed at bringing down the cost of both healthcare and health insurance in Connecticut.

Lawmakers from both parties admitted past efforts haven’t provided the relief voters want, but promised the issue is a priority this session.

“What we heard in the election, what we’ve heard from our constituents is we’ve got to focus on affordability in this state,” Sen. Matt Lesser (D-Middletown) said.

Lesser, co-chair of the Human Services Committee, and other Democrats offered some specifics, including cracking down on pharmaceutical benefit managers and trying to import prescription drugs from Canada, but said the proposals are a work in progress.

Sen. Tong Hwang (R-Fairfield) a co-chair of the Insurance and Real Estate Committee, agreed that the goal is to field suggestions from everywhere.

“We're going to have these public hearings and we’re going to have input from all interested parties and we’re going to find out what is the best way,” Hwang said.

Democrats said they want to give pharmaceutical benefit managers, or PBMs, a fiduciary responsibility to patients.

This would allow patients, or the attorney general, to go after PBMs who don’t.

PBMs are middlemen who negotiate lower prices on prescription drugs, but critics say many profit instead of passing those on to patients.

A Federal Trade Commission report earlier this month found those PBMs pocketed $8.7 billion in savings that never trickled down to customers between 2017 and 2022.

Democrats also want to make it harder for health insurers to deny a request for prior authorization by forcing them to prove why they denied a doctor’s request for care.

Hwang said Republicans are open to all ideas but also want to push a bill that would allow small businesses to pool together to purchase insurance.

Additionally, they want to force the healthcare industry to provide more data to the Office of Health Strategies for price benchmarking.

Connecticut is one of a handful of states that tries to set goals on price growth, but has struggled to get the information regulators and lawmakers believe they need.

Health insurers say the moves could just drive up costs while impacting only a small amount of insurance plans.

“It’s important to note that with respect to any proposal aimed at insurance, Connecticut’s regulatory authority only extends to less than 25% of the commercially insured population and those are individuals and small employers who are extremely price sensitive,” Connecticut Association of Health Plans Executive Director Susan Halpin said in a statement.

“That’s something we all must be cognizant of as we consider additional legislation,” Halpin continued.

But the Connecticut Business and Industry Association applauded lawmakers for looking at ways to bring down costs.

“Connecticut businesses, in our survey, that’s the number one issue they want legislators to tackle so they can bring down those costs for employees,” CBIA Vice President of Policy Chris Davis said.

The Insurance and Real Estate Committee failed to approve a single bill ahead of its deadline last session.

Sen. Jorge Cabrera (D-Hamden), a committee co-chair, said that won’t happen again this year.

“Every time, we start over and we’re going to get our work done and we have a lot of important issues we have to address,” Cabrera said about the new session.

Lawmakers are concerned about federal funding, though, as President Donald Trump and a Republican-controlled Congress consider cuts to Medicaid and other social services.

Connecticut lawmakers have expressed a desire to raise reimbursement rates.

Some Democrat also want to raise the age on undocumented immigrants who can receive Medicaid. The state currently offers coverage to those 15 or younger.

Lesser said that at least for now, he won’t let funding threats halt those conversations.

“We’ll see, we just have to look at what we can do to protect our residents here and expand coverage here,” Lesser said.