A deeply diluted version of an ambitious public option health care bill moved through the House Tuesday, drawing bipartisan support but abandoning once-hopeful plans to impose a state mandate and arrange discounted coverage for small businesses and individuals.
The final measure included a requirement that health care providers submit annual reports on the prices they impose, the costs they incur and the payments they receive. Lawmakers would set yearly benchmarks to contain the swelling cost of care, and work with providers who exceed that threshold. There are no penalties if an organization surpasses the benchmarks, which have not yet been determined.
The bill also allows state officials to seek permission from the federal government to import prescription drugs from Canada at reduced prices, and it enables them to pursue a reinsurance waiver to mitigate risk from sizable claims. Insurers and health care centers would pay an annual fee, and the money would be used to cover large medical bills to keep premiums down.
The legislation’s passage followed weeks of debate, several revisions — and a fair bit of drama.
Rep. Sean Scanlon and Sen. Matthew Lesser, the bill’s authors, originally proposed opening the state’s health plan to small companies and nonprofits, forming an advisory council to guide the development of a public option, and creating a discount program to provide savings on prescription drugs. Those plans were voted out of committee but overhauled in a new draft of the measure that was rolled out last month.
The second attempt would have authorized the creation of a “Connecticut Option” – a state-subsidized health plan for small companies and individuals. To help pay for it, lawmakers wanted to re-establish the penalty for failing to comply with the federal health coverage mandate. The bill would have effectively reversed – in Connecticut – Congress’ decision to remove the edict in the Affordable Care Act that all adults have health insurance, either through their jobs, Medicaid or by purchasing it directly.
The revised legislation also included a tax on opioid manufacturers that was expected to raise $20 million per year.
Those provisions were stripped from the final version.
Scanlon said compromises with health providers, insurance companies and fellow lawmakers prompted some of the changes, but the bill also ran into difficulty after Comptroller Kevin Lembo told The Hartford Courant last week that Cigna had threatened to leave the state if the public option cleared the General Assembly. Cigna officials have denied the claim.
Some lawmakers interpreted the insurer’s input as a push for revisions, not an actual threat. But Lembo’s remarks cast a shadow over subsequent negotiations.
Scanlon said despite the stripped down bill’s circuitous route to passage, he was happy with this year’s effort.
“I think this bill is going to lead to real savings for people in Connecticut, and it’s a great step in the direction of lowering overall health care costs,” he said.
Legislators in the House voted 112-28 in favor of the measure, which still needs approval from the Senate. The legislative session ends Wednesday at midnight.
Scanlon hopes to reignite discussion on a public option next year.
“Lowering health care costs is not a ‘one and done’ proposition. It takes years and years of cumulative efforts,” he said. “We’re going to get back to work the day after the session ends to figure out what we’re going to do next year.”