My little investigation in Connecticut shows, however, what reporters are up against—bureaucrats who don’t particularly want to talk, and who must walk a fine line between the insurance industry’s needs to sell and make a profit and the public’s needs to buy at a reasonable price. Plus: reporters—and customers—are up against insanely complex products, which some insurers are not keen for the world to understand. Here is where you need a expert, perhaps a friendly actuary.
Perhaps all that helps to explain some of the coverage in Connecticut so far. The Exchange website lists and links 19 stories between the end of June and mid-December. Many have been the soft variety—the Hartford Courant announcing the schedule of town hall meetings the Exchange has conducted with state residents; greenwich time.com reporting Connecticut is ready for Obamacare; HartfordBusiness.com telling readers about the selection of Counihan as CEO. There have been others. Madrak said “we’ve been mentioned in the press hundreds of times in the last couple of months.” But, observes Jill Zorn, senior program officer for the Universal Health Care Foundation of Connecticut, “nobody is covering it regularly.” Janet Davenport, the foundation’s vice president for communications, says the exchange does not generate “the kind of news that would draw television.”
Still there are some exceptions to the generally soft coverage. Controversy draws reporters, and there has been plenty of that in Hartford. Arielle Levin Becker, who covers insurance for The Connecticut Mirror, an online operation, reported on the unhappiness of consumer advocates about who had been appointed to the board. Connecticut state law prohibits exchange board members from being affiliated with insurers or health industry groups, but consumer advocates said three members had come out of the insurance industry.
The CT News Junkie, meanwhile, reported that healthcare advocates also questioned the investments of some board members. One had investments in such companies as Pfizer, Quest Diagnostics, and Aetna. The News Junkie reported the board member Grant Ritter had no plans to divest himself from his assets unless he was asked to. He said disclosure was enough. Time will tell if it is.
Levin Becker advised reporters not to shrink from writing about “the really basic stuff.” “I’ve been surprised by how many generally well-informed people have told me they don’t understand what an exchange is,” she said.
And explainers are only one part of this new beat. Much of what exchange officials do “is fairly controversial,” she said. Levin Becker pointed to one issue she has tackled that is critical to consumers’ options: How selective should exchanges be in choosing health plans to sell to the public? Should they choose only the best plans or allow all carriers to offer products? For now, Connecticut’s exchange will allow any plan that meets certain standards. The exchange could get crowded, though, and board members might reconsider.
Another critical and potentially controversial question: How much authority should the exchange should have to regulate insurance premiums? Levin Becker wrote an interesting and substantial story about the exchange’s contentious late November meeting, at which the board decided it would not negotiate rates with the carriers. Greg Bordonaro, writing for the Hartford Business Journal, described the looming battle over negotiating rates. While the Connecticut exchange board has already chosen not to negotiate rates with insurers, leaving that task up to insurance regulators—who are cozy with the industry in the Insurance Capital of the US—the state legislature may have other thoughts. Bordonaro’s good piece laid out a scenario that could break up the customary relationship between regulators and the regulated.
And that circles back to the big news question that came out of the Connecticut exchange’s December meeting, though apparently ignored by the press: Those whom Obamacare is intended to help may not be helped at all, if they can’t afford the insurance.
The Second Opinion, CJR’s healthcare desk, is part of our United States Project on the coverage of politics and policy. Follow @USProjectCJR for more posts from this author and the rest of the United States Project team. And follow Trudy Lieberman @Trudy_Lieberman.
The ‘Man in the Middle’ hits a healthcare Catch-22