Senate Democrat leaders continued releasing their legislative agenda at the Capitol, this time focused on healthcare, including expanding mental healthcare services for children, increasing Medicaid coverage, decreasing prescription drug costs and reforming insurance practices they say cause delays in healthcare.
“Health coverage and access to health coverage is an issue we keep facing year after year and will be a significant focus for us this session,” said Senate President Pro-Tem Martin Looney, D-New Haven. “Everyone in Connecticut needs and deserves confidence that when they need healthcare, they will be able to receive it in a way that is not financially crushing.”
Democrats are looking to build upon recommendations made by the Comprehensive Needs of Children in the State task force and provide additional funding to school-based health centers, including providing resources to “identify and diagnose children in need of assistance.”
Connecticut’s mental health system was strained prior to the pandemic, but the isolation and anxiety of those years pushed that system to the breaking point, with a lack of hospital mental health beds, therapists, psychologists and psychiatrists. The effect was particularly pronounced in children who had to spend months out of school participating in online learning. The lawmakers are looking to states like Arkansas and Florida as possible models for what they’re hoping to do in Connecticut.
Democrat leaders are also looking to streamline insurance authorization for prescription medications, including creating a “Gold Card” for prior authorization for medications or services, thus eliminating often lengthy wait times for doctors. A similar law was passed in West Virginia in 2019 and in Texas in 2021.
Speaking on the issue, Sen. Saud Anwar, D-Windsor, a practicing physician, said the wait times for doctors can be onerous and lead to delayed care. According to a survey of physicians by the American Medical Association, 93 percent of respondents reported prior authorization requirements delayed care, and 87 percent reported it can lead to patients abandoning a course of treatment.
“One out of five physicians in the state of Connecticut are working about 35 hours per week to get prior authorization either for medications or your tests or your procedures,” Anwar said. “The overwhelming majority of physicians are spending a minimum of nine hours per week for prior authorizations. And the interesting thing is, the overwhelming majority of those prior authorizations are actually approved, except the challenge is the time that was lost which was there for the purpose of taking care of patients is gone.”
They also seek to reform “step therapy,” in which insurance companies require lower levels of treatment therapy before moving on to other forms of treatment, even when doctors believe they already know which treatment will be most effective.
“There has to be a way to get around that when it is clear what the needed treatment is and people are being made to needlessly suffer before they access, if they ever do,” Looney said.
These proposals would also require insurance companies to have 24/7 staff coverage to respond to prior authorization, a proposal Democrats said they could legally require, and extending the amount of time a parent has to put their newborn child on their health insurance.
Democrats are also proposing to join with other states in an effort to lower prescription drug costs through ArrayRx, a program launched in Oregon that basically pools together multiple entities to purchase drugs at lower costs through negotiations with pharmaceutical companies. The program is also in use in Washington.
Finally, Democrats are seeking to increase Medicaid coverage through the CoveredCT program created in 2021 that allows some eligible individuals to pay nothing for their healthcare coverage obtained through Access Health CT.
“We can build on that this year,” said Sen. Matthew Lesser, D-Middletown, and chair of the Insurance and Real Estate Committee. “We can expand Medicaid to ensure nobody falls through the cracks. If you are elderly, if you low income, if you are a child or a person with disabilities… we can cover you.”
“Building on recent reforms that congress just passed to allow Medicare to negotiate the price of prescription drugs, Connecticut can do our part, we can work with other states to bring down the cost of prescription drugs for everyone in the state,” Lesser said.
This was the third day of Senate Democrat leaders holding a press conference to announce their agenda. Their previous agendas included Safer Connecticut, which addresses domestic violence, online safety, transportation safety and mental health and addiction treatment. Senate Democrats also announced their intentions to more fully monitor education spending by municipalities, implement workplace scheduling rules and require employees who receive tips to receive the state’s full minimum wage, rather than the sub-minimum wage.