Koller

Doctors, small-business owners and other allies of Health Insurance Commissioner Christopher F. Koller began campaigning Friday to save Koller’s job and the law that created it after a surprise vote in the House Finance Committee on Wednesday sought to eliminate the commissioner’s three-member office.

“Bad. Bad. Bad. Bad,” Steven R. DeToy, lobbyist for the Rhode Island Medical Society, said of the plan, which still requires approval from the full House and Senate. “I don’t know that anyone saw it coming.”

Koller’s office, DeToy said, has “saved millions and millions of dollars for the employer community” by keeping health insurance premiums in check.

Lt. Gov. Elizabeth H. Roberts, who helped craft the 2004 law creating Koller’s post when she was a state senator, said she did not know why the Finance Committee moved to eliminate the job and repeal the law.

“I am working hard to see it reversed,” Roberts said. “I think it’s a very poor decision, especially now.” Roberts led a meeting of business leaders, health-care providers and others Friday morning to strategize ways to save the commissioner’s position.

Closing Koller’s office would save the state $700,000. Although all parts of state government are expected to cut staff, Koller’s is the only position that the Finance Committee’s proposed budget specifically eliminates.

“You wonder what the rationale for it is,” said Michael Vittoria, president of the Rhode Island Business Group on Health. “The health insurance commissioner’s office has been really one of those key elements to moving health-care reform in the state — controlling costs and increasing transparency….

“It’s not often that businesses come out strongly in favor of keeping a government office or government program that is basically designed to be regulatory in nature,” Vittoria added. “This shows the value of this office and what it means.”

Some found the vote especially surprising because the Finance Committee chairman, Rep. Steven M. Costantino, D-Providence, was an architect, with Roberts, of the 2004 law that established the Office of the Health Insurance Commissioner. The law gave the state new powers to regulate health insurers and protect consumers and providers.

Costantino did not respond to a request for comment Friday. On Thursday he said that the commissioner’s duties could be handled by other state agencies.

Others disagreed. “We’ll really be rolling back the clock to a day when there was less oversight, less control on the behavior of health insurance companies,” said Rick Brooks, director of United Nurses and Allied Professionals and co-chairman of the insurance commissioner’s advisory council.

Dawn Wardyga, director of health and public policy for the Rhode Island Parent Information Network, said that before Koller’s office was established, consumers often had nowhere to turn for help with their health insurers. “Since we’ve had an insurance commissioner we’ve had that kind of protection in place. And I have referred many, many families to that office,” said Wardyga, whose agency provides information and support to parents.

“I think it would be a real disaster for health care if they eliminated it,” said Dr Albert J. Puerini, a Cranston family doctor who has worked with Koller on a nationally recognized pilot project to improve the care of the chronically ill. Koller spearheaded that project, and it is not likely to survive without him, Puerini said.

“He’s the first person on the scene in Rhode Island and especially in this administration who has really grasped what the problem is with health care,” Puerini said.

Edward J. Quinlan, president of the Hospital Association of Rhode Island and a member of the commissioner’s advisory council, didn’t take a position but said he sympathized with the legislature’s financial struggles. He also questioned whether the office was ever adequately funded.

Before Koller’s office was created, the Department of Business Regulation was responsible for protecting consumers and for ensuring that health insurers were financially solvent. The 2004 law gave the insurance commissioner new powers over health insurers: he could require them to treat providers fairly, to make health insurance affordable, and to work toward improving the health-care system.

Koller has created a structure that enables the public to understand and comment on proposed premium increases. In the past, rate increases were submitted whenever the insurers felt they needed more money, and people learned about higher rates when they received their bills.

Koller has now required health insurers to submit their proposals simultaneously, and provide specified information that is made available to the public. Recently he held a public hearing on three insurers’ proposed increases, and on Thursday declared them all unjustified.

Rep. Elizabeth M. Dennigan, D-East Providence –– a member of the House Finance Committee –– said she first learned of the plan to cut Koller’s office on Wednesday when it appeared as part of the state budget that the committee was voting on. After the vote, Dennigan called Koller — and that was the first Koller learned of any effort to eliminate his position, she said. She advised him “to advocate and tell us about the good things he’s doing so we could reconsider and restore.”

Dennigan, who voted in favor of the budget, faulted Koller for not being “more visible” and making sure legislators knew about his accomplishments. But she called him “one of the smartest people we have in state government. … I think he does a great job.”

Dennigan expressed confidence that Costantino, who has devoted much of his legislative career to health issues, would not let the session end without making sure consumers and businesses had the necessary protections in place. “He’ll do the right thing,” she predicted.

rsalit@projo.com