Data from the Comptroller's Office on the state-run insurance program. MLR means "medical loss ratio." FAD is "funds awaiting distribution."

Health care is complicated policy made personal, as the choices made in Congress and state capitols have a direct impact on the financial and physical wellbeing of everyone in our country. Here in Connecticut, it can be hard to keep track of what’s going on as multiple bills and an influx of well-funded misinformation collide in the news and on the desks of legislators.

Comptroller Kevin P. Lembo ctmirror.org file photo

Here’s where we stand.

The health care crisis in Connecticut continues. Different bills attempt to address this crisis in different ways — including President Biden’s American Rescue Plan, which provides important short-term assistance to help people afford coverage in the individual market. Other bills under consideration in Connecticut expand subsidies, attempt to lower prescription drug costs and address long-standing health care inequities. There is room to incorporate the best of each if it helps make health care in our state more affordable, equitable and accessible. But Senate Bill 842 is the only bill that provides short and long-term help for small businesses, nonprofits and certain labor unions.

As each policy gets considered and debated, it’s critical that we don’t continue to leave small businesses and nonprofits behind.

Some members of the Insurance Committee attempted to do just that. An amendment was added to SB 842 to eliminate the public option and lock small businesses out from benefitting from the cost-saving and patient wellness programs of the state health plan — the plan those very same legislators use to receive insurance for themselves and their families.

Those programs include some of the lowest prescription drug prices in the nation and a nationally renowned preventive health program that helps patients manage chronic diseases and prevent expensive emergencies. It also includes the Network of Distinction, an initiative of mine that Gov. Ned Lamont is rightfully excited about. With this program, I contract directly with state hospitals and doctors that meet superior patient experience standards for entire episodes of care — from evaluation to recovery. The program uplifts Connecticut hospitals and providers, improves the patient experience and saves money by reducing expensive complications and eliminating unnecessary services.

That work is being done right now in my office. The question for lawmakers is who gets to benefit from it? Legislators should allow their constituents to share in the success of their health plan.

Local governments are already showing how this can work. Through the Connecticut Partnership Plan, non-state public employers can buy into the state health plan. Over 140 groups have chosen to do so and now cumulatively provide good health coverage to nearly 60,000 teachers, first responders, frontline municipal workers and their families. That plan is financially self-sufficient and continues to improve, as is detailed in a March report.

In the public option legislation, risk management measures are required to further eliminate risk to taxpayers. My office must purchase stop-loss insurance and build a reserve fund to cover any possible overage if claims were to outpace program premiums. We can provide small employers relief from poor health care coverage and high costs without jeopardizing state finances or asking more from our residents. It’s a simple choice.

The powerful interest groups — including many well-financed ones who travel across the nation opposing all reform efforts — are already deep into their misinformation campaign. Their argument boils down to this: Small businesses don’t matter as much as insurance jobs and we will not support a single person gaining coverage if it means $1 less for us.

The specific, often contradictory, spokes of their argument break down under minimal critical thinking.

No. Offering small businesses and nonprofits a new choice for health care isn’t a “take over” of the insurance industry. The state health plan works with many large insurers who compete with each other for that business.

No. Offering new choices won’t eliminate jobs at Connecticut insurers — they’re not covering those groups now. Our state has over 700,000 workers at small businesses, yet the small group insurance market covers only a fraction of them.

And no. We can’t wait for the federal government to solve all of our problems. We’ve been burned playing that game in the past, and the very same groups opposing the public option are spending millions of dollars to make sure reforms crash and burn in Congress as well.

The situation is untenable. The people of Connecticut — including over 70 percent of small business owners — support new public options for health care. SB 842, as originally written, is our best chance to meet their demands and bring meaningful change that can start benefitting everyone in our state.

Kevin Lembo is the State Comptroller.

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