Backlash grows over state health plan, AG calls it a 'huge deal'

Attorney General Maura Healey said in a radio interview on Tuesday that the Group Insurance Commission should reconsider its plans to restructure health insurance plans for state workers.

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By State House News Service

The backlash against the Group Insurance Commission and its decision to cut some health plans offered to state workers, including Fallon Health, has been steadily growing, with more key lawmakers and the Attorney General speaking up against the move on Tuesday.

House Majority Leader Ron Mariano wrote to the chair of the GIC, Valerie Sullivan, requesting that the Legislature be given a detailed explanation of how the agency arrived at the decision to slash the number of health plan options from six to three for state employees, and Attorney General Maura Healey called the rollout of the changes "seriously mishandled."

Meanwhile, House Democrats vented during a private caucus on Tuesday about being blindsided by the decision, according to members who were present, and some lawmakers are beginning to explore their options for a possible legislative response.

The swirling tempest around the commission's health plan consolidation threatens to become a self-inflicted black eye for Gov. Charlie Baker as he kicks off his re-election year this week with a major address to the state and the release of his fiscal 2019 budget.

"The decision to consolidate the current commercial health plans from six to three leaves great uncertainty for individuals and families who rely on the GIC for healthcare coverage," Mariano, a Quincy Democrat, wrote to Sullivan. "This is a major shift in policy that leaves significant questions unanswered and no guarantees for folks that they would continue to have access to their same doctors and current services."

Fallon Health among plans on chopping block

The GIC voted 8-5 last Thursday to contract with three health insurance carriers – UniCare, Neighborhood Health and Health New England – to provide coverage to the nearly 450,000 state workers and retirees. The change eliminates Harvard Pilgrim Health Care, Worcester-based Fallon Health and Tufts Health Plan as carriers, and would save the state an estimated $20.8 million next year.

Union representatives on the GIC voted against the plan, and labor leaders quickly condemned the process as one that gave little time for employees to understand the impact of the changes.

"GIC leadership continues to engage with union leadership and other key stakeholders about how this vote will help ensure members can keep their doctors, hospitals and benefits. This procurement was done to maintain high-quality benefits and doctor choices while saving GIC members and the state money. We anticipated health care cost increases of 5% or more for GIC members without these changes," GIC chief of staff Ashley Maagero Lee said.

The GIC has defended the process that it says began in July and included regularly communicating with union representatives on the commission about the direction of the new carrier procurement and the possibility of consolidation. Those union members, GIC officials said, voted to approve minutes of past meetings where the possibility of a consolidation was discussed.

The Group Insurance Commission is currently conducting nine listening sessions over 10 days around the state to gather feedback and help it prepare for two upcoming votes in February to lock in benefit design and rates. But the first meeting in Worcester last Friday turned into a "circus," according to state Rep. James O'Day, of Worcester.

O'Day showed up to testify, and told the News Service Tuesday it was the "most unprofessional hearing I've ever been associated with."

"It was really poorly presented. Every question being asked of the GIC, they seemed to be taking it almost personally, and I can't believe they weren't anticipating the kind of pushback that they got," O'Day said.

"For them to try to say 100 percent of those people that are losing their carriers that all those people were going to be able to keep their same doctors, I think that's a reckless statement for them to make," he added.

O'Day said he's working with other legislators to look into their legislative options. Acting Senate President Harriette Chandler also testified at the same Worcester hearing expressing her "severe displeasure."

Mariano requested that the GIC provide his office, and the entire Legislature, an explanation of how the bids from health plans were scored and how the potential savings were calculated.

Noting that 200,000 members will be impacted by the changes, Mariano also drew attention to the fact that the three insurers excluded from the GIC have been "key partners" in health reforms in Massachusetts over the years, and are major employers who could be negatively impacted.

Healey said during a radio interview Tuesday that the GIC "should very seriously reconsider" its decision which was made at a time when the health economist position on the board is currently vacant.

"This is a situation that was seriously mishandled, lacking in the appropriate transparency. And from the calls that I've received in my office over the last week, this is a huge deal," Healey said during an interview on WGBH's Boston Public Radio on Tuesday.

Healey said it remains to be seen, or proven, how the consolidation will impact premiums and continuity of care for members, and what it might do to the broader health care market. UniCare, an Indiana-based, for-profit insurer has a history of paying hospitals and other providers less for services, Healey said.

"Twenty million dollars, it sounds like a lot. It's not a lot in term of savings, in my view, given the complete disruption this has caused," she said.

House Speaker Robert DeLeo said he heard a lot of concerns raised during the Democratic caucus Tuesday about the GIC vote, but said he wasn't sure what the Legislature could or could not do with respect to the commission's vote.

"I think we can make our opinion known," DeLeo said.

He continued, "The rollout, the way it was just sprung on people, probably wasn't the best. I guess the first hearing that was held out in Worcester probably didn't go the best. Having said that, they're making the assertion that people are going to be paying less and getting just as good of care. I'm not sure we're all convinced of that, and in the days and weeks to come we're going to have to see more evidence of that."

Baker last Friday said the commission, by rebidding its health and pharmacy plans, was trying to address the "big message" the GIC has heard from employees - that their premiums and out-of-pocket health care spending were rising faster than their pay.

Former Newton Mayor Setti Warren, one of three Democrats running for governor, on Monday called the situation a "travesty," and former state budget chief Jay Gonzalez, who left government to run CeltiCare Health, said Tuesday the GIC vote was an "insult to these workers who perform critical public services every day." "Once again, Charlie Baker can't see the people through the budget line items. Hundreds of thousands of hard working state and municipal employees and retirees have been blindsided by this massive disruption in their healthcare," Gonzalez said in a statement.

The GIC's latest public hearing on the plan took place Wednesday morning in Pittsfield.