Assembly Health and Senior Services Committee Chair Herb Conaway, Jr., M.D. held a joint hearing of his committee along with the Assembly Regulatory Oversight Committee on Wednesday to examine the issue of tiered health insurance networks, which has raised concerns in recent months over certain parts of the state being shut out from access to premium health coverage.
Hospitals in Conaway’s 7th legislative district have been left out of Horizon Blue Cross Blue Shield’s new Omnia Health Alliance plan, which will provide select coverage for its insured at only 22 state hospitals, leaving others with higher premiums and deductibles if they utilize hospitals not designated in the plan.
“This hearing today was ultimately about two important issues – protecting consumers through transparency and ensuring access to critical health care.
“There are an untold number of alarm bells being set off by the shift to tiered health insurance plans. It’s clear that these plans will have an impact on costs, consumer choices, and the delivery of hospital services.
“In my district, as well as many urban areas throughout the state, hospitals have been completely shut out of this premiere plan, forcing residents to pay higher premiums and deductibles to access hospital services in their immediate vicinity.
“Another important concern is that hospitals are typically one of the largest employers in the communities they serve. What will happen if this tier plan drives consumers away from certain hospitals that aren’t part of the Tier 1 designation? And what will the impact be on physicians and, consequently, the patients they serve?
“It’s become apparent through this hearing that there are a number of things we need to figure out – how we determine access to care; how that’s to be measured; how it’s done in an urban versus suburban setting; and how these tiers are developed. One thing that’s clear is that it should be an open and transparent process that minimizes the risks and possibilities of conflicts of interests. I think you can achieve that while still being able to benefit from the cost-saving measures included in tier plans,” said Conaway (D-Burlington).