The Insurance and Real Estate Committee of Connecticut convened on February 18, 2025, to discuss House Bill 6,871, which aims to limit out-of-network health care costs. Governor Lamont's proposal seeks to cap these costs at 240% of Medicare rates, effective January 1, 2027. This cap is designed to address the significant financial burden on consumers, who currently face charges as high as 750% of Medicare for out-of-network services.

The rationale behind the proposed cap is threefold: it aims to exert downward pressure on in-network negotiated prices, encourage more providers to participate in networks, and ultimately enhance consumer access to care. The Connecticut Insurance Department's data indicates that the current out-of-network costs can be excessively high, making the proposed cap a necessary measure for consumer protection.

Additionally, the governor's proposal stipulates that any savings resulting from these caps must be returned to consumers through reduced insurance premiums. Insurers will be mandated to report on how these savings are utilized to lower costs for policyholders.

The committee acknowledged the existing federal and state No Surprises Act, which addresses some out-of-network issues, and expressed commitment to ensuring alignment with the proposed legislation. The discussions highlighted a significant step towards improving health care affordability and access for Connecticut residents.