Connecticut-based Coalition Urges Legislators to Strengthen Senate Bill 379 to Ensure Patients are Fully Protected from Midyear Health Plan Changes

Hartford, CT (April 9, 2018) – The Connecticut Non-Medical Switching Coalition, a collection of patient and provider groups fighting to ensure consistent access to care for Connecticut consumers, today called on state lawmakers to strengthen Senate Bill 379 to ensure patients with commercial health coverage receive the benefits they signed up for throughout each policy year. While Senate Bill 379 aims to help protect Connecticut families by requiring health insurers to give a 60-day notice when benefits change, it does not fix the problem by prohibiting insurers from making unfair changes in the first place. The current version of SB 379 was voted out of the Appropriations Committee this week in a 42-7 vote and is anticipated to head to the Senate next.

Without an improved version of Senate Bill 379, nothing prohibits commercial health insurers in Connecticut from making prescription coverage changes mid-year, even though consumers and families are essentially locked into their health plans. Throughout the year, health plans are raising out-of-pocket costs, enacting coverage restrictions or even removing coverage altogether.

“I never knew an insurer could unexpectedly remove a medication from its formulary until it happened to me,” said Shawn Lang, Deputy Director at AIDS Connecticut (ACT), who has osteoporosis. “The particular medication I was prescribed was to be taken once a month, but when I went to pick up my re-fill, I was told that my insurance no longer covered that medication. Just out of the blue.  No notice, no explanation.  Fortunately, I’m someone who can advocate for myself and was able to get a different prescription.  But what about someone with a chronic health condition, or someone who doesn’t have the same capacities that I do?”

“Health insurance companies should have to honor their contracts just like any other business,” Rep. Michelle Cook (D-Torrington) said. “Non-medical switching hurts patients who are trying their best to manage medical conditions, and it undermines doctors’ ability to provide their patients appropriate treatment. I’m advocating for legislation to end this harmful practice because consumers and patients deserve better.”

“When a health insurer revises a drug formulary during the term of a policy, patients in Connecticut can lose access to the vital medications their physicians who are the experts prescribe. This can lead to the possibility of adverse outcomes, additional testing requirements, and an increase in the cost of treatment for the patient,” said Sen. Heather Somers (R-Groton), Co-Chair of the Public Health Committee. “This legislation is not only a matter of ensuring contractual fairness for the consumer who has purchased a specific insurance plan, but it is also an important public health and total health care cost issue.”

 

About the Connecticut Non-Medical Switching Coalition

The Connecticut Non-Medical Switching Coalition is a collection of patient and provider groups working to ensure that commercial health insurance benefits will be concrete over the course of each year. All we ask is that insurers honor contracts with patients. Members include: AIDS Connecticut (ACT), American Liver Foundation, American Lung Association in Connecticut, Arthritis Foundation, Coalition of State Rheumatology Organizations (CSRO), Epilepsy Foundation of Connecticut, Global Healthy Living Foundation, Lupus and Allied Diseases Association, National Infusion Center Association (NICA), National Multiple Sclerosis Society, National Organization for Rare Disorders (NORD), Patients Rising Now, Reflex Sympathetic Dystrophy Syndrome Association (RSDSA), U.S. Pain Foundation. For more information, follow #DontSwitchMeCT on Twitter.