The New York State Department of Financial Services is holding a hearing on September 8 to learn more about how New York could be affected by a merger between Anthem and Cigna. Any interested person can submit comments in writing, or even better, attend a hearing on the issue this Thursday in downtown Manhattan. The hearing starts at 10:00AM, on the 6th floor at 1 State Street.
HCFANY has expressed concerns about this merger before, and will do so again on Thursday. The hearing is completely open to the public (you can review the public notice here). Anyone can testify by signing up in advance (just email email@example.com, and put “ANTHEM-CIGNA 2016 HEARING” in the subject line). HCFANY’s testimony recommends that DFS reject the merger, for the following reasons:
- The Anthem-Cigna merger will reduce competition in New York State.
- Competition produces better services at lower costs, even in the complicated world of health insurance.
- Remedies or conditions used by regulators in past health insurance mergers have failed to truly protect consumers.
You can read our talking points here for help in crafting your testimony, but the important thing is to tell your own story – DFS wants to hear from you! HCFANY believes this merger will make issues like customer service and affordability even more difficult for New Yorkers, and we think New Yorkers should let DFS know how those problems are affecting them. Even if you do not want to speak in public about the merger, it is important for consumers to attend the hearing – it shows DFS that we care about this issue. If you cannot attend, you can also submit written testimony up until September 15.
Once again New York is leading the nation as one of only two states to implement a Basic Health Plan (BHP). As of January 31, 379,599 New Yorkers enrolled in comprehensive, affordable coverage through the New York’s BHP, branded the Essential Plan, which launched in 2016. A few weeks ago, the NY State of Health (NYSOH) released its report on the third open enrollment period, which ran from November 1, 2015 through January 31, 2016. HCFANY is excited to see so many consumers gaining access to health care through the EP in its first year.
The EP is meeting an important need for consumers in New York, particularly for those with incomes between 138 and 200 of the Federal Poverty Level (FPL). Before the implementation of the Essential Plan, individuals at this income level would only have been eligible to purchase Qualified Health Plans (QHP) with financial assistance, and many continued to face financial barriers to coverage. With the EP, low- and moderate income individuals can now receive coverage comparable to that of a QHP for a premium of $0 or $20 and no annual deductible. The average consumer saves over $1,100 compared to QHP coverage. This increased affordability has resulted in high enrollment levels for EP eligible individuals. According to NYSOH’s open enrollment report, 98 percent of individuals determined to be eligible for the Essential Plan enrolled compared to only 58 percent of individuals eligible for QHP.
Essential Plan coverage is also available to individuals under age 65 with incomes below 138 percent of the Federal Poverty Level (FPL) who are lawfully present in the United States, but have not met the five-year bar to qualify for Medicaid as well as lawfully present immigrants with incomes 138 to 200 percent of FPL.
Like Medicaid and Child Health Plus, individuals and families eligible for the EP can enroll throughout the year.
To enroll or learn more about the Essential Plan, contact NYSOH at (855)-355-5777 or www.nystateofhealth.ny.gov.You can also get free one-on-one help from a Navigator or Certified Application Counselor, certified by NY State of Health, who serves your area at http://info.nystateofhealth.ny.gov/IPANavigatorMap. Or contact Community Health Advocates at (888)-614-5400 or http://www.communityhealthadvocates.org/.
Late last week, the New York State Department of Financial Services (DFS) called for a hearing to discuss the consequences of a merger of the Anthem and Cigna health insurance companies. HCFANY applauds DFS for this action. HCFANY wrote to DFS in early March shortly after the potential merger was announced. In the letter, HCFANY urged the Department to carefully review this merger and hold a public hearing on how it affects competition in the state Marketplace, which ultimately impacts the costs of premiums and quality of care for consumers.
This merger would combine the second-largest and fourth-largest health insurers in the country and reduce the number of major health insurers in the U.S. from five to three. According to a recent article in Politico, this would mean that Anthem’s total market share would increase to 31 percent in New York State. In the New York Metropolitan area, Anthem would control almost 70 percent of the commercial self-insured market in three of the five boroughs. Increased market share would give Anthem the ability to dictate prices for providers and likely have a negative impact on access to health care for New York’s consumers.
If you would like to weigh in on the proposed Anthem-Cigna merger, there will be a public hearing held on Thursday, September 8 at 10:00 AM in New York City. If you are interested in testifying at the hearing, please write to DFS at New York State Department of Financial Services, Public Affairs Office – Anthem-Cigna Merger New York, NY 10004 OR e-mail firstname.lastname@example.org with the subject line: “ANTHEM-CIGNA 2016 HEARING.” Requests to testify must be received at least five business days prior to the hearing.
For the fourth year in a row, New York State received an “F” in an annual report on price transparency when paying for health care. The grades are published every year by the Catalyst for Payment Reform (CPR), an organization that wants to improve health care by changing how it is paid for.
Part of changing health care is giving consumers accurate price information so they can choose affordable providers. We’ve written before about how hard it is for consumers to get information about prices from New York’s hospitals. As the authors of this new report say, getting the price of a service before receiving it is “the very minimum amount of information a consumer would expect in any other transaction.”
New York is not alone – 43 other states also got failing grades. But there were successful states that New York could learn from. For example, Colorado’s Medical Price Compare website allows consumers to search for prices according to zip code and type of insurance, and links that price information to quality and customer service measures.
Colorado was able to build their consumer website because it has something called an all-payer claims database. An all-payer claims database is the best source of information about health prices, because it collects information about the actual bills that consumers and insurance plans paid. New York started working on an all-payer claims database in 2011, but we’ve received an “F” every year from CPR because it has no public component, and because the law creating our database says nothing about sharing the data with the public.
It’s time for New York to prioritize transparency in the health care market, and that starts with asking us what we need to become informed health consumers. One way to demonstrate the importance of this issue would be to convene a state-level consumer transparency task force, with strong consumer representation. The state has identified consumers as an important stakeholder, and indicated that a consumer-facing website will be part of the project in the future. But consumers have been told to take more responsibility for health care costs for years now through higher deductibles and higher cost-sharing, without being given meaningful information about their choices. After five years of planning for the claims database, it is fair to start asking when and how consumers will benefit. A task force with adequate consumer representation would be one way to ensure that progress is made and that the end results are guided by consumers’ priorities.