House Advances Healthcare Legislation, Including Pooling & SustiNet
It didn’t include everything proponents wanted, but the House passed a bill Friday that attempts to combine the pooling power of the state employees health care plan with those of municipalities and some nonprofits.
The bill is similar to ones House Speaker Chris Donovan proposed in 2008 and 2009 under former Gov. M. Jodi Rell, who vetoed it twice.
“It’s a good model that will save cities and towns money and put us on a path to affordable, accessible health care,” Donovan said.
Donovan’s bill which he calls the Healthcare Partnership was combined with a proposal being called SustiNet, but it’s not the version that initially called for the state to pool together state employees, Medicaid recipients, municipalities, nonprofits, and small businesses. The version passed Friday opens the state employees and retirees health care pool to certain municipalities and nonprofits which have contracts with the state.
Juan Figueroa, president of the Universal Health Care Foundation, said the bill that passed Friday—no matter what it’s called—opens up the state employee health insurance plan to municipalities and some nonprofits, which was always part of the SustiNet proposal.
“It takes concrete steps in the right direction and offers a commitment to look at adding a nonprofit public option,” Figueroa said. “It’s about tying together federal and state reform in this infrastructure.”
But House Minority Leader Lawrence Cafero, R-Norwalk, said the measure could potentially bust the state budget. Now that the state will be self-insured it has to make sure its claims match its expenditures and if it decides to open up the pool to a high-risk nonprofit or municipality, it will be the taxpayers that are on the hook, Cafero said.
Cafero said he can’t believe the Democrats, who supported more progressive versions of both bills had the gall to stand up on the floor today and endorse this bill, which isn’t completely offensive to the health insurance industry.
“It’s somewhat comical,” Cafero said.
Keith Stover, a lobbyist for the Connecticut Association of Health Plans, said he’s very encouraged by the Malloy administration’s commitment toward setting up the federal health care exchanges through the creation of the new office of Health Reform and Innovation.
The legislation passed Friday also creates a 21 member policy board to continue studying reform models, such as a public option to be offered on the exchange.
“You can study, analyze, and plan all you want, but you can’t print money,” Stover said implying the cost of the full SustiNet proposal would have been too high.
He applauded the Malloy administration for realizing that and making it a goal to set up the federal exchanges. It was a move that took SustiNet proponents by surprise and left them scrambling to save what they could of their reforms.
The bill passed Friday also made changes to the health insurance industry as a whole, which Stover opposes.
A portion of the bill prohibits insurers and utilization review companies that grant prior authorizations for admissions, services, procedures, or extensions of hospital stays from reversing or rescinding the authorization under several circumstances.
Rep. Linda Schofield, D-Simsbury, said that means if an individual gets a prior authorization for knee surgery decides to delay it for a month, then switches jobs the insurance company for the employer he just left gets stuck footing the bill. She said that’s absolutely a provision that will raise insurance rates across the board.
Stover said currently prior authorization is one of the tools insurance companies use to keep costs down. If you take that tool away from them costs will go up.
“An essential component of any successful plan is creating a rationale around utilization,” Stover said.
It was still unclear Friday if the state would exempt itself from the provision.
Members of the Healthcare4Every1 campaign, which is funded by the Universal Health Care Foundation, stood outside the House chamber to show their support for the bill. Gathered in their trademark red shirts the members said the bill helps move the state in the right direction.
David Amdur, an organizer for the Connecticut Center for a New Economy, believes this bill lays the framework for people without healthcare to have access in the future.
“It lays the structure for universal healthcare,” said Amdur about the bill, noting the business plan required by next year is where he believes the public option can be contemplated. “The public option is
what we need, we are laying the infrastructure for that.”
Amdur would not be directly affected by this bill but said, “people that I am working with who don’t have access to healthcare will get a chance to get access.” He added, the larger pool of beneficiaries created sends a powerful message.
Michele Mudrick, a congregational organizer for United Church of Christ, agreed with Amdur that having a line in the budget and the infrastructure in place moves the issue in a direction she is happy with for the future.
Among the group outside the chamber was a retired state employee Bill Fredrickson, who left the Department of Developmental Disabilities in June 2099. He said the bill would help some groups that have been troubled with high rates.
“It is a step forward, it is not going to fix everything,” said Frederickson. “It’s a way of creating better efficiency and will really help municipalities and small employers who are paying a hefty price right now.”
Fredrickson noted the state employees he spoke with are behind this bill and the movement forward to giving more employees affordable healthcare.
Nicholas Rondinone contributed to this report.