The Connecticut public option idea is good policy
It's pragmatic, thoughtful, and should take a big bite out of health care costs
If you’ve been paying attention to Washington, DC, progress on health care has been at a near standstill for the last decade since the passage of the Affordable Care Act. Ideology and politics has made progress on more affordable health care difficult if not impossible. Reasonable people can’t get in the same room and where disagreement exists, demonizing opponents instead of listening is the order of the day.
Which is why the recent proposal in Connecticut over a Connecticut Option is such a breath of fresh air. The proposal by Gov. Ned Lamont, Comptroller Kevin Lembo, and the legislature— especially Sen. Matthew Lesser and Rep. Sean Scanlon— at its core will cut the cost of health insurance for Connecticut small businesses and individuals by a target of 20 percent, although when you add up the provisions, the savings could be even higher.
Additional features, like reinsurance, cost monitoring measures, a request to the Federal government to allow for safe drug re-importation, and incentives for more healthy people to join the insurance pool should keep costs stable over the long term. An expansion of HUSKY, the state’s Medicaid program. paid for by a tax on opioid manufacturers, will cover thousands more low income people and improve hospital bad debt.
This is good policy.
But it’s also occurred with a process that could teach Washington a thing or two. Comptroller Lembo’s office conducted public hearings and focus groups with small businesses, both Democrats and Republicans, to understand their biggest pain points — the growing expense of providing health benefits to attract and retain employees — that could be addressed legislatively.
The governor consulted widely and broadly, and worked with the legislature and the Comptroller’s office, to get the best ideas to the table. Rather than be adamant about something that hews to an ideology but is flexible on the details, Gov. Lamont and the legislative leaders remained fixated on the endpoint — lower costs for the people of Connecticut— and flexible to approaches. It is a lesson Washington can surely learn from.
The end result is a proposal that cleverly uses the private sector to deliver on the needs of the legislation, but allows them to leverage the government’s purchasing power and the state employee plan, to make it happen and ensure competition.
Ideologically, this proposal has the benefit of being difficult to categorize as being in any particular camp. Families, small businesses, and advocates can take stock that the government is using its power for their benefit to lower their health care costs. And if businesses and families see reduced costs, private insurers can demonstrate why they can be a part of any solution — something some Americans remain skeptical of. For that reason this is a model it is easy to see replicated in other states.
My experience over many of these efforts, both nationally and in states, is that there are often parties who resist changes to the status quo and plant fear of change more broadly. This hasn’t happened here. Even as they expressed concern over the pace of change, insurance companies have avoided unhelpful rhetoric and even heaped praise on the governor and his team for working through the details in an open and collaborative fashion. The insurers should be even more enthusiastic. More far-reaching health care proposals recently passed in places like Colorado and Washington state and neither carry this level of opportunity for the insurers to be part of the solution.
Health care reform and governing are not linear straightforward processes, always giving critics ample opportunity to Monday-Morning quarterback. But Americans rank health care affordability as their top issue for government to solve and are in no mood for ideological battles that don’t lead anywhere.
By acting on this proposal, the legislature, in partnership with Gov. Lamont, has the opportunity to put Connecticut in the lead by introducing a model for the country that is pragmatic, thoughtful, and should take a big bite out of health care costs. The people of Connecticut should be cheered at seeing this acted on and approved.
Andy Slavitt is the former Acting Administrator for the Centers for Medicare and Medicaid Services from 2015-2017 under President Obama and is the current Founder & Board Chair of United States of Care.
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