Officials weigh reform’s impact on state

Now that an overhaul of the national health care system has been signed into law, state officials and the health care industry are scrambling to determine what it means for Connecticut.

“We are still digging through it,” said State Health Care Advocate Kevin Lembo. He estimates 260,000 people in Connecticut will gain coverage by 2014 – shrinking the ranks of the uninsured from 10 percent to 2 percent.

But other questions remain, including what the reform bill will cost Connecticut, how it will be implemented, and what it means for the state’s own plans for a health insurtance program.

Republican Gov. M. Jodi Rell has asked her budget director, Robert L. Genuario, and Department of Social Services Commissioner Michael P. Starkowski to assess the costs to the state, both now and in the coming years and report on Monday.

“We’re the ones left to figure out the bill, left to see if it can work and determine how much it will cost.” Rell said. “This much, however, I can tell you already: Connecticut, like nearly every other state, cannot afford millions and billions in costs that Washington passes along. It’s that simple.”

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Genuario said he saw no huge costs for Connecticut in a preliminary review of the measure. “Give me until Monday and I will have a better estimate,” he said.

Starkowski and Department of Public Health Deputy Commissioner Christine Vogel are currently reviewing how to implement the law.

Vogel is co-chair of the Connecticut Health Care Advisory Board and heads the Rapid Review Board, two panels Rell created to assess the effect of the federal reform bill. Vogel said she will submit the Advisory Board’s recommendations to Rell by Jan. 1, but had no timeline on when the Rapid Review panel will report.

It’s already clear that implementing the reform bill will be a “huge undertaking,” Vogel said, given that she expects 72,000 more people will become eligible by 2014 for the federally-funded, state-administered Medicaid program.

“Our system now can’t handle that. We are talking about building on a system that isn’t really working well now. … At least we have a few years to work it out,” Vogel said.

Lembo is also facing a deadline to assess the bill for the legislature, as the co-chairman of the state’s SustiNet Board. The SustiNet panel was created to make recommendations on implementing federal reform and to develop a supplemental state health care program with a “public option” for people unable to buy private insurance.

The SustiNet board has until May 21 to report how to implement the federal law, though Lembo says he hopes to have the report done before the legislative session adjourns May 5 in case any legislative action is needed. It has until Jan. 1 to propose a state health insurance program.

Lembo said he expects Connecticut to go beyond the federal reform efforts.

“They set this new federal floor. Some states will chose to do nothing additional, but Connecticut I am confident will go above that,” Lembo said.

Ellen Andrews, director of the Connecticut Health Policy Project and member of the SustiNet Board, said a public option is essential for people “falling into a black hole trying to find affordable private insurance.” A public option provision was removed from the federal legislation.

But lobbyists for the Connecticut health insurance industry and the Connecticut Business and Industry Association said a state-run public option is a bad idea.

“The history is that government insurance does a bad job,” said Eric George, CBIA’s health care lobbyist.

Keith J. Stover, a lobbyist who represents the Connecticut Association of Health Plans, said the state should first see the effects of national reform before acting on SustiNet.

“If the federal bill takes a significant bite out of the number of uninsured then what are we even doing trying to move on SustiNet?” he said. “The state needs to take a breath and let this catch up.”