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DearConnecticutHealthExchangeBoardMember, CongratulationsonyourappointmenttotheBoardoftheConnecticutHealthInsuranceExchange.Asa coalitionofconsumeradvocates,wewanttothankyouforagreeingtoserveonthiscriticalBoard.We thankyoufortakingresponsibilityformakingcomplex,difficultdecisionsthatwillimpactthehealthand financesofoneintenstateresidentsdesperateforaffordable,comprehensivehealthcoveragewhoare expectedtopurchasecoveragethroughtheExchange.iTheeffectivenessoftheExchangeinproviding affordable,comprehensiveinsuranceoptionswillbecriticalsinceeverystateresidentwillhavethe responsibilitytosecurecoveragein2014,andespeciallysofortheestimatedhalfofExchange consumerswhowillqualifyforadvancedpaymenttaxcreditsandwhomustpurchasecoveragethrough theExchange.TheExchangefacessomedauntingtasksintheverynearfuture,andwewanttoextend anoffertoadviseandassistyouasyoubeginthisimportantwork. Amongthosedauntingtaskswillbedefiningthebenefitsthatmustbeofferedbyplansintheexchange, consideringthosemandatedunderstatelawinadditiontothoseincludedinthefederalessential benefitpackagedueoutthisFall.AnotherimportanttaskwillbesettingstandardsforQualifiedHealth Plans(QHP)andchoosingthosePlansforparticipation.

n.Connecticuthashadatroubledpastinchoosing healthplansforourHUSKYprogram;weurgeyoutoreviewthathistorytoavoidpastmistakes.Itis essentialthatQHPshaverobustproviderpanels,andthatsafetynetprovidersbeavailabletoensure continuityofcareforconsumerswhomaytransitionbetweenMedicaid,aBasicHealthProgram,and coveragethroughtheExchange.TheBasicHealthProgramisacriticaloptiontoensurecontinuityof careforindividualsfluctuatingaboveandbelow133%ofFPL,aswellasaccesstoanaffordablebenefits package.CoordinationbetweentheExchangeandthesepubliccoverageprogramsiscriticaltoensure thatapplicantsareawareofeveryavailableoption,andsotheycaneasilyshiftfromoneprogramtothe otherastheirincomechanges. YouwillalsobechoosingNavigatorstoassistconsumersinpurchasingtherightplantomeettheirneeds andresourcesinacomplexandconfusingenvironment.Wecannotoverstatetheimportanceof effective,appropriateoutreachandeducationaleffortstoensurethateverystateresident,regardlessof circumstances,isawareofalltheiroptionsandhaseverytoolnecessarytomakethebestdecision. AppropriateNavigatorsmustbeavailableacrossawiderangeofculturesandcircumstancestoensure thattheExchangemeetsthediverseandcomplexneedsofpeoplewithdisabilitiesandspecialhealth careneeds. Yourdecisionsmustcarefullybalancesettingstandardsthatensurethatcoverageisaffordableand meaningful,butalsoflexibleenoughtoprovideconsumerswithabroadsetofoptions.Itiscriticalthat ExchangestandardsandrulesfosterarobustmarketofinsurerscompetingforConnecticutresidents business,andmaintainingalevelplayingfieldwithplansofferedoutsidetheExchange.TheBoardmust evaluatethefunctionoftheExchangeinprovidingvaluetoconsumersanditsroleinConnecticuts complexandquicklychanginginsurancemarket,andquicklyadaptpoliciesandplanchoicestomeetthe needsofconsumers. TheGeneralAssemblywasverywiseinincludingstronglanguageinPA1153toexcludeBoardmembers withobviousconflictsofinterest.ThoseprovisionsarecriticalnotonlytoensuringthattheBoard makesthebestdecisionsforConnecticutconsumers,butalsotoensuringpublicconfidenceinthose decisions.Wearecertainthat,regardlessofbackground,everyBoardmemberwillmakethebest interestsofconsumersandsmallbusinessestheirfirstpriorityindecisionmaking.

Wethankyouforyourcommitmenttopublicservice.Pleasecontactanyofusifwecanbeofhelpin thisimportantwork. Sincerely, JenniferC.Jaff AdvocacyforPatientswithChronicIllness,Inc. ShawnM.Lang ConnecticutAIDSResourceCoalition MaggieAdair ConnecticutEarlyChildhoodAlliance JenniferCarroll ConnecticutFamilySupportNetwork EllenAndrews ConnecticutHealthPolicyProject ShirleyBergert ConnecticutLegalServices SharonD.Langer ConnecticutVoicesforChildren
Nicholas P. Yorio Greater Hartford Legal Aid

DomeniqueThornton MentalHealthAssociationofConnecticut,Inc. AliciaWoodsby


National Alliance on Mental Illness, CT (NAMI-CT)

SheldonToubman NewHavenLegalAssistance i DAuerbachet.al.,TheImpactoftheCoverageRelatedProvisionsofthePatientProtectionand AffordableCareActonInsuranceCoverageandStateHealthCareExpendituresinConnecticut,RAND, 2011http://www.rand.org/pubs/technical_reports/TR973z1.html