Monday’s CT Insurance Dept. (CID) hearing on the acquisition of Health Net’s license by United Healthcare was fascinating. If you didn’t hear anything about it, you’re not alone. It was not well publicized, there was little time to respond, and the hearing was not held at the Legislative Office Building, but in a windowless room, down a maze of halls, in the back of the CID offices in Hartford. Just to set the tone of the hearing, the pens for visitors to sign in with at the CID offices carry the United Healthcare logo. The CT Health Policy Project, the CT State Medical Society, the American Medical Society and Patient Advocacy Institute had already been denied intervenor status in the proceeding; apparently CID does not believe that consumers and providers have a critical interest in the proposal.
In an unprecedented arrangement, United is not merging with Health Net (which is leaving CT), but simply buying all their information about us. They can then choose which of us, possibly based on our health status, they will offer to insure. They can also decide what they will charge us. United could more than triple their share of CT’s health insurance market; studies have found that less competitive markets lead to higher premiums for everyone. CT’s health insurance market is already too concentrated and we are at high risk for anti-trust concerns. Also, consumers who are lucky enough to be defaulted into a United policy may have to change doctors and medications. United’s provider panel is sparse in areas of the state and they have a different formulary than HealthNet. Also, as a matter of privacy, United will now have sensitive personal health information on about 200,000 state residents that we never consented to share with them. Health Net is now under investigation for losing a hard drive with Medical claims data. I also pointed out that all those 200,000 HealthNet members already had the choice of insuring with United and rejected it. To default them into a plan they already rejected is not doing them any favor.
For two hours, United’s own lawyers were able to ask their own executives and consultants softball questions extolling the virtues of the proposal. Then CID staff asked technical questions for another hour. Interestingly, United happened to have a large chart display just to respond to one of the CID staff questions. Then we had our turn at the podium. The CT State Medical Society, the Office of Health Care Advocate, the Center for Medicare Advocacy, the American Medical Society, the Patient Advocacy Institute, Middlesex Professional Services and the CT Health Policy Project all testified in opposition. We got very few questions. Then the United witnesses were asked softball questions by CID staff allowing them to rebut any of our concerns (I’m told lawyers call that rehabilitating the witness). One of those questions to the insurer asked whether actual workers in a small business have a role in choosing the insurance plans offered. United, as experts on small businesses like ours, answered that only owners have that choice. I guess that means that consumers really don’t have a voice in choosing health plans, only employers. (In our small group the opposite is the case, but I wasn’t given an opportunity to say that). We were only allowed to submit any written comments for a few hours, however United was given until 4pm the next day to submit anything they choose.
Democracy in action.