Democratic leaders in the House and Senate, fresh off election wins, are laying out a key goal of the 2021 legislative session two months in advance: passing a public option health insurance plan.
The measure failed in 2019 and was shelved this year when the state suspended its regular session amid the coronavirus pandemic. But Democratic lawmakers say that with COVID-19 cases on the rise and hundreds of thousands out of work, the need to expand government-run health coverage is more pressing now.
“At the exact moment when people in Connecticut need health insurance more than ever, we are seeing an increase – a huge and disturbing increase – in the number of our residents who lack access to affordable, quality health care,” said Sen. Matthew Lesser, D-Middletown, a co-chair of the Insurance and Real Estate Committee. “A new legislature has been elected that ran on this issue, that has talked about this issue, and that has made promises to the American people in Connecticut that we are going to deliver real reform.”
As they have in the past, officials with the state’s insurance companies expressed opposition to the concept of a public option.
“Assuming this is the same version of government-run health care pushed by the comptroller in years past, the health insurers in the state will adamantly oppose it,” said Susan Halpin, executive director for the Connecticut Association of Health Plans, which lobbies on behalf of insurers. “It’s a proposal that’s failed before with good reason. It establishes a false promise that’s already proven unsustainable in the limited form it exists today.”
In an early draft of the 2019 bill, legislators had hoped to open the state’s health plan to nonprofits and small companies – those with 50 or fewer employees – and form an advisory council to guide the development of a public option. Comptroller Kevin Lembo said at the time that his office would partner with insurers under an umbrella contract to provide plans outside of the state’s risk pool. The legislation also would have allowed the state to form “ConnectHealth,” a program offering low-cost coverage to people without employer-sponsored insurance.
Later that year, legislators unveiled a sweeping overhaul of that bill. The second version would have established the “Connecticut Option” – a state-sponsored plan available to individuals and small businesses funded by reviving the individual mandate, a requirement that people obtain health coverage or face a financial penalty. Legislators also suggested raising money for the program by levying a 1-cent-per-milligram tax on opioid manufacturers. The revised bill, which also included the restoration of cuts to the state’s Medicaid program and approval to import drugs from Canada, was watered down before passing the House. It did not win approval in the Senate.
The latest proposal, rolled out in March, would have allowed small businesses, nonprofits and labor unions to join the state-operated Connecticut Partnership plan, which already is available to municipalities, and it would have created a third option for individuals on Access Health CT, Connecticut’s insurance exchange. Two carriers currently offer individual plans on the exchange. A week after the March 5 release of that concept, the Capitol closed for deep cleaning. Lawmakers did not return for the regular session.
On Thursday, Lembo joined lawmakers in pledging a resurrection of the public option bill. He revealed few details about what the newest version would look like but said officials would again try to use the state’s purchasing power to negotiate an insurance plan for individuals.
“We are very likely to see a leveraging of the state employee pool using that pricing and those 220,000 lives that are in there to get better deals and offer more opportunities,” Lembo said. “So, leveraging it through partnership, leveraging it through the state employee plan, but setting up different benefit designs for these populations that are affordable and accessible for them, not necessarily the one product that we’re offering now just to state employees.”
“The backstop is the state of Connecticut. I’m not going to run away from that,” he added. “But you set your premiums according to the risk profile of the people who are coming in.”
Despite President-elect Joseph Biden’s support for a public option, Democrats said Thursday that they don’t want to wait for “the gridlock” in Washington, D.C. to subside before making progress. Uncertainty surrounding the balance of power in the U.S. Senate means Biden’s health reform agenda may not be successful, they said.
“There is not a majority in the United States Senate to support President Biden in his effort to make health care more affordable, which means it’s going to fall to the states to act,” said Rep. Sean Scanlon, D-Guilford, a co-chair of the Finance, Revenue and Bonding Committee. “Even though we have a new president … there’s still going to be paralysis there. That’s why it’s up to us here in Connecticut, because our constituents simply can’t wait any longer for the politics of Washington to work in their favor. They need the politics of Hartford to work in their favor.”
Republican legislative leaders, who did not participate in the Democrats’ announcement Thursday, signaled that they would not support a public option bill.
“The Democrat proposal of a public option, I fear, will not accomplish our shared goal of reducing costs and increasing accessibility and will simultaneously threaten thousands of good paying jobs,” Senate Minority Leader Kevin Kelly, R-Stratford, said. “The Democrat plan aims to move insurance jobs under the scope of government, put government in charge of health care with little regulation or requirements to even abide by the Affordable Care Act, and compete with a private industry using taxpayer dollars as a backstop. If claims exceed premiums, taxpayers will be the ones on the hook.”
Rep. Vincent Candelora, R-North Branford, said the proposal would threaten jobs in the insurance sector and “harm the pandemic recovery we all hope for.”
“I appreciate Democrats’ passion in pursuing affordable health care … unfortunately, they’ve been campaigning for 20 years on the promise of doing something about it but have instead continued to implement more taxes, more consumer-paid assessments, and more regulations that have driven premiums upward,” he said. “I look forward to learning more about their unwritten proposal.”
“The Partnership Plan has run multi-million dollar deficits over the past few years,” Halpin said. “At the same time, it sets the state up to compete with its own signature industry on an un-level playing field. When you peel back the layers of the onion, the proposal just doesn’t work and it does more harm than good.”