Gov. unveils proposals to reduce health care costs

Gov. Lamont proposes bills to help reduce health care costs
Published: Feb. 21, 2023 at 9:26 AM EST|Updated: Feb. 21, 2023 at 7:55 PM EST
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NEW BRITAIN, CT (WFSB) - Connecticut’s governor unveiled legislation on Tuesday that would lower health care costs.

Gov. Ned Lamont participated in a news conference on Tuesday morning at Beacon Prescriptions in New Britain.

Lamont proposed House Bill 6669 and Senate Bill 983, which he said would eliminate unnecessary health care charges, reduce healthcare prices, and increase health care affordability for Connecticut residents and employers.

He said it would also out an emphasis on enhancing competition.

“Gallup recently reported that record-high numbers of Americans are putting off care due to costs,” Lamont said. “Approximately 38 percent of Americans put off care in 2022, the highest percentage Gallup has ever seen in its 22 years of polling. Two-thirds of personal bankruptcies are related to medical debt, the most common cause of bankruptcy, and healthcare is consuming a larger and larger percentage of GDP, now more than 18 percent. We simply can no longer afford not to take action. These bills I’m proposing tackle this complex problem from multiple angles, and I am calling on all parties – insurers, hospitals, doctors, employers, and consumers – to join with me in working on solutions for the people of Connecticut.”

“Access to affordable and quality health care is one of most important issues facing Connecticut families and businesses at a time when costs are rising and insurance covers less than it used to,” said state Comptroller Sean Scanlon. “The fight for better health care for the people of this state is one of my biggest priorities as comptroller, and I’m proud to be working with Gov. Lamont to pass a ‘patients first’ health care reform agenda that will lower costs and ensure everyone has access to the care they deserve.”

Here’s the legislation, according to the governor’s office:

  • Eliminates hospital facility fees charged at free-standing offices and clinics.
  • Implements stronger regulatory enforcement tools at the Connecticut Office of Health Strategy to assure compliance with certificate of need requirements and related conditions of approval, such as cost controls, patient access, and detailed reporting. This will curb health care costs by preventing duplicative services in specific areas, while ensuring availability and access to critical services in all parts of the state.
  • Commits Connecticut to joining a multistate bulk purchasing consortium to negotiate prescription drug discounts that all of the state’s residents will be able to access through a discount card at their pharmacy.
  • Requires the Connecticut Office of Health Strategy to annually publish a list of prescription drugs that are experiencing major price spikes to inform consumers and prescribers about which drug prices are going up and by how much.
  • Reins in aggressive marketing practices by pharmaceutical representatives to ensure prescribers get clear and accurate information about the drugs they prescribe and generic alternatives. Pharmaceutical representatives will be required to complete a training, register with the state, and disclose relevant information about drug costs and efficacy across different races and ethnicity, if known.
  • Strengthens protections to ensure that discounted prescription drugs purchased through the federal 340B program benefit the low-income consumers and communities the program was designed to help.
  • Prevents price gouging when patients get care from a provider who is not in their network. Specifically, the governor is proposing to limit out-of-network costs for inpatient and outpatient hospital services to 100% of the Medicare rate for the same service in the same geographic area.
  • Outlaws the use of anti-competitive contracting practices that have been used by health systems to impede competition and increase prices. This will provide health insurers with additional bargaining power to make it easier to negotiate affordable prices for consumers. These include:
  • Anti-tiering clauses: Requiring a health plan to extend a preferred value tier status to all facilities or provider in a health system, even if certain providers do not meet cost or quality standards for that tier.
  • Anti-steering clauses: Prohibiting insurers from using incentives to steer patients to higher value providers.
  • All-or-nothing clauses: Requiring health plans to accept all providers in a healthcare system or none of them.
  • Gag clauses: Preventing parties from disclosing relevant information, including price or terms of an agreement to a third party.

The Connecticut Hospital Association responded to some of these proposals, and says the facility fees help support off-site clinics.

“The facility fees are a way that hospitals support enterprise and services closer to the community,” says Paul Kidwell from the Connecticut Hospital Association.

The Connecticut Hospital Association feels there should be more pressure on insurance companies to help reduce costs.

House Bill 6669 has been referred to the Public Health Committee, and Senate Bill 983 has been referred to the Insurance and Real Estate Committee.

Gov. Lamont unveils proposal to reduce health care costs
Gov. Ned Lamont participated in a news conference on Tuesday morning at Beacon Prescriptions in New Britain.