The legislature’s Insurance and Real Estate Committee advanced priority legislation last week that seeks to create an enforcement mechanism to ensure that insurance companies abide by Connecticut’s mental health parity law.
What happened: The Insurance Committee voted 10 – 3 to send Senate Bill 10 to the Senate floor for consideration.
Why it matters: S.B. 10, a priority bill for the General Assembly’s Senate Democrats, contains several pro-consumer health insurance protections, including:
- New enforcement mechanisms to make sure insurance companies do not make coverage of mental health care more restrictive than coverage of medical care.
- Assumes that health care claims ordered by doctors are medically necessary and requires insurance companies to conduct a review before claiming a procedure is not medically necessary.
- Restricts the use of “step therapy,” a tactic used by insurance companies to avoid covering higher level treatments recommended by doctors.
- Prohibits artificial intelligence from making determinations about which treatments are necessary.
- Prohibits any health insurance policy from imposing arbitrary time limits on general anesthesia services, as Anthem Blue Shield-Blue Cross attempted to do in December.
What people are saying:
Senate President Pro Tem Martin Looney: “Senate Bill 10 makes major strides in this regard as far as ensuring real mental health parity in practice, making sure that physicians have a final say on care instead of some artificial intelligence program, and that anesthesia patients will not be left without coverage for necessary anesthesia due to some misguided, cost-saving insurance regulation.”
Sen. Jorge Cabrera, Senate chair of the Insurance and Real Estate Committee: “The health insurance industry changes day by day, week by week. If we are to keep up with those changes and ensure that Connecticut’s residents are not taken advantage of, and that they receive the legal protections that we as a legislature have said that they are entitled to, we need to update our laws on a regular basis. That’s what Senate Bill 10 does.”
Who voted against it: Three Republicans on the Insurance Committee voted in opposition to the health care protections:
- Sen. Tony Hwang, R-Fairfield
- Rep. Cara Pavalock-D’Amato, R-Bristol
- Rep. Tammy Nuccio, R-Tolland
Public feedback: At its March 6 public hearing, S.B. 10 was attacked by insurers but praised by health care consumers, including Daniel Christiansen, who said he’d seen first-hand how insurance companies created barriers to treatment for a loved one who lives with mental illness.
“If Connecticut fails to strengthen parity enforcement and transparency, families will continue to face higher costs, longer waitlists, and worsening mental health outcomes,” Christiansen said.
