12 at the Capitol: Hearing tackles health care costs, but parents are skeptical

State officials held an all-day hearing to tackle Connecticut health care costs.

John Craven

Jun 25, 2024, 9:01 PM

Updated 26 days ago


State leaders held an all-day hearing on rising health care costs Tuesday, but parents remain skeptical that prices will actually level-off.
Manny Romero, of Norwalk, has a 3-year-old boy. But the cost of raising a child is growing faster than his son is.
“The food is more expensive,” Romero said. “Health care is more expensive.”
Connecticut lawmakers want to help. On Tuesday, the state Office of Health Strategy held a hearing to explore why costs are rising – and how to keep prices in check.
“We know that this is leading to delays in care,” said Dr. Deirdre Gifford, the OHS commissioner. “It’s leading to avoidance of care, and it’s leading to medical debt.”
From 2021-22, per person health care spending jumped 3.4% – exceeding the state’s 3.2% target – according to a recent OHS Cost Growth Benchmark report. The report also found that Connecticut insurance premiums have nearly tripled over the past two decades, from $6,300 per year in 2001 to nearly $25,000 in 2022. Employees are now paying a higher share of premiums too, OHS found.
The report says prescription drug prices and hospital visits are the biggest cost drivers. OHS found that inpatient prices in Bridgeport and New Haven are 40% more than the national median.
Gov. Ned Lamont proposed legislation to penalize hospitals that don’t meet cost benchmarks, but the Connecticut Hospital Association argued that OHS’ data is flawed.
“OHS has yet to implement a transparent data process for accurately assessing performance against the benchmark,” CHA told state lawmakers earlier this year. “The data provided to OHS by the health insurance companies does not match the experience of the advanced networks. There is no transparency regarding how patient spending is attributed to individual advanced networks, and OHS provides little assistance to adjudicate the significant data discrepancies.”
As for drug prices, the state says the popular arthritis drug Humira is the most expensive drug in Connecticut, costing a total of $130 million in 2022. Amgen, which manufacturers Humira, declined to appear at Tuesday’s hearing, along with two other drug makers.
But it’s not just pharmaceutical companies. Experts told Tuesday’s panel that part of the blame lies with Pharmacy Benefit Managers. PBMs are “middlemen” between pharmacies, drug makers and insurance companies – but it’s unclear exactly knows how much PBMs make.
The state employee health system has had success lowering PBM costs, but they said monitoring costs is too time-consuming and labor intensive for many self-insured employers. Lawmakers are likely to take up additional PBM reforms next year, but major impacts aren’t likely unless Congress acts.
“Why is it that all other developed parts of the world do not have PBMs, and the people are doing well and the cost is much less?” said state Sen. Saud Anwar (D-South Windsor), who is also a pulmonologist.
Back at the playground, Romero appreciates the effort. But he doesn’t think health care will ever be affordable.
“Cheaper? I don’t think it will ever be cheaper,” he said.

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