Senate Democratic leaders on Tuesday unveiled their health care reform agenda for the legislative session that begins next month, saying they would aim to cap the price of insulin, limit the cost of other prescription drugs and extend certain types of insurance coverage to people aged 26.
The lawmakers also are planning a revival of the controversial public option bill, though several have quietly acknowledged that the measure is unlikely to pass this year.
Few details about the proposals were offered Tuesday by the senators, who all face re-election next fall. The announcement gave them an opportunity to shift away from the more contentious topics of transportation and tolls and focus on an issue many believe will be key at the polls in November.
It was unclear Tuesday if Gov. Ned Lamont supports the Senate Democrats’ broader health agenda, but sources said he embraces one aspect of it — cost containment — and will announce as early as Wednesday his plan to use his executive authority to set benchmarks for limiting price increases by providers and insurers.
“The question right now isn’t whether or not we need reform. The question is: What kind of reform is best for Connecticut? What’s best for people across the state and what’s achievable?” Sen. Matthew Lesser, D-Middletown, said.
Legislators said their goal is to drive down the cost of health care by 20% or more, but gave no specifics about how that might be accomplished.
At the center of their reform package are the prescription drug proposals. While few details were revealed about the insulin bill – a longtime priority for Insurance Committee Co-chairs Lesser and Rep. Sean Scanlon, D-Guilford – lawmakers said it is modeled after an effort in Colorado that caps co-payments on insulin at $100 a month for insured patients, regardless of the supply they require. Insurance companies must absorb the balance.
The Colorado law, signed by Gov. Jared Polis in May, also directs the state’s attorney general to launch an investigation into how prescription insulin prices are set throughout the state and make recommendations to the legislature.
The Health Care Cost Institute has reported that Type 1 diabetes patients – who generally must inject themselves every day — paid an average of $5,705 for insulin in 2016, nearly double what they paid four years earlier. Over the last decade, the list prices of some types of insulin have tripled, even though they’re the exact same products offered 10 years ago.
The dramatic price hikes have left some people with Type 1 and Type 2 diabetes who use insulin to control their blood sugar levels in the position of making dangerous compromises. They either go without medication or ration their prescribed dose to prolong it until they can afford the next prescription.
Democrats said the insulin bill will have several components, including a provision that gives people emergency access to the drug if they’re away from home or not near a pharmacy.
“We are committed to the basic idea that nobody in Connecticut should die because they don’t have access to insulin,” Lesser said.
The legislative leaders said they would use last year’s revised public option bill – the version released in the waning weeks of the session – as a starting point for the newest effort. A watered-down version of the plan cleared the House but died in the Senate last spring.
The measure was wide reaching, incorporating everything from a state-sponsored plan known as the “Connecticut Option” to the resurrection of the individual mandate – the requirement that people have health insurance or pay a penalty – to help pay for it.
It also featured a tax on opioid manufacturers, an expansion of HUSKY A coverage, a drug importation provision, and a proposal to cap the soaring cost of health care by requiring providers, insurers, drug makers, and others to submit plans on how they would bring those costs back under a state-imposed limit.
People with knowledge of Lamont’s plans say the governor will use executive authority to both set benchmarks for limiting price increases and to require health care providers and insurers who surpass the limit to draft plans for curtailing those costs. Lamont could announce the move as early as Wednesday, sources said.
A spokesman for the governor did not return calls seeking comment Tuesday.
In addition to the public option and insulin bills, legislators want to propose other measures for reducing the cost of prescription drugs; to expand dental and eye insurance for people aged 26 who are on their parents’ plans (the current age limit is 25); to enhance patients’ rights by allowing them to share personal stories with insurance companies when a new medicine or test is ordered; and to create more protections at the state level in case the Affordable Care Act is repealed.
Connecticut offers some protections in the event that the federal health law is wiped out, including coverage that is known as “essential benefits” for people with pre-existing conditions. But legislators say they want to explore additional measures given the uncertainty around the ACA.
The health law has been embroiled in a legal challenge by the Trump administration and officials from several Republican-led states, who say that without the individual mandate, the rest of the ACA in invalid. A group of attorneys general from Democratic states asked the Supreme Court earlier this month to review a lower court decision that found the ACA’s individual mandate to be unconstitutional.
The Supreme Court on Tuesday denied a motion to fast-track a challenge to the health law so that it could be considered by the end of June.
“Here we are at the state level, wanting to do all that we can to protect the Affordable Care Act … to ensure our constituents remain healthy,” Senate Majority Leader Bob Duff, D-Norwalk, said. He gave no examples of the additional protections being considered.
Missing from the Senate Democrats’ reform package were two controversial proposals that are expected to be debated in the coming months: An effort to repeal the state’s religious exemption from vaccines, and a plan to ban the sale of flavored tobacco and vaping products.
Senate President Pro Tem Martin Looney said legislative leaders will share more on those issues in the coming weeks and are planning an announcement with their counterparts in the House.
Republican Senate leaders said Tuesday they have a shared goal of making health care more affordable, but they objected to the idea of a public option.
Representatives for the state’s insurance industry also have remained firm in their objection to the expansion of state-sponsored coverage.
“Connecticut’s bipartisan health care reforms have made our state a national leader in addressing problems … but one-sided proposals like a public option that are formulated without all voices and ideas at the table have never proven successful,” Senate Minority Leader Len Fasano, R-North Haven, said. “A public option could move our state closer to substandard coverage. It also could threaten thousands of middle-class jobs in the insurance industry.”
If The State of CT were a private corporation, we would fire the CEO if she did not use her power to bring down health expenses. So, good effort State!
But let’s make the savings available to all CT businesses. It would be a mistake to have the state contract for lower medical fees and then have the provider community turn around and bill the private sector more to make up the difference.
Whatever the state does, the private sector should also have access to the same discounts. That will help both the state budget and the budgets of every Connecticut company creating jobs here.
James Stirling