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House Advances Healthcare Legislation, Including Pooling & SustiNet

by Christine Stuart | May 27, 2011 8:23pm
(11) Comments | Commenting has expired
Posted to: Health Care, State Capitol

Christine Stuart file photo

House Speaker Chris Donovan

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.

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(11) Comments

posted by: DrHunterSThompson | May 27, 2011  8:56pm

DrHunterSThompson

Vote NO! to concessions.

posted by: Wakewhenover | May 28, 2011  9:36am

This is what you get when you elect a liberal Democrat governor with a super super super liberal legislature.  The gates are down, the stop gap that was Rowland-Rell is over. It’s now Christmas(can Istill call it that in this state?) every day for these “progressives.”

posted by: NOW What? | May 28, 2011  8:42pm

SEBAC union members - Please ignore “DrHunterSThompson” and the like; he’s not a State employee union member, and if the new SEBAC agreement gets rejected through union voting we can kiss our right to bargain over pension and health insurance GOODBYE because the legislature will vote to get RID of that right.

‘Nuff said.

posted by: DrHunterSThompson | May 28, 2011  9:09pm

DrHunterSThompson

stevehc - we have a contract until 2017, what are you talking about?

posted by: Pdg | May 28, 2011  9:40pm

To SteveHC, where will it stop then?  I’d rather have an honest gun fight than die by a thousand paper cuts.  We will end up in the same place either way.  When they come back in 2 years and ask for more will you just rollover then.  When they come back in 4 years and ask again for more will you just rollover then.  When is enough,  how much are you willing to give up before you say stop?

posted by: ... | May 29, 2011  5:04am

...

I’m curious where this argument really came from? This article has no word of concessions or the union agreements in it. And yet the first comment about the story seems like a spam posting with no relation to the issue of expanding health care availability while reducing inefficiency costs.

posted by: NOW What? | May 29, 2011  11:51am

This bizarre, “machismo” chest-thumping laden with false bravado inherent in “Vote No!” proclamations can get us all killed politically, financially and economically. Better to accept contract modifications now than to lose benefits and bargaining rights.

We’re dealing with and living in the PRESENT, not 10 or 20 years ago, Times have changed, and so must we if we are to survive with collective bargaining rights, decent pay and benefits, and decent defined-benefit pensions with retirement healthcare benefits.

posted by: DOT Worker | May 29, 2011  9:48pm

2. House Bill 6308 (With Amendments A and D)

In a nutshell, this provides that if SEBAC gives their written consent, nonstate public employers and nonprofit employees and their retirees may join the state employee health plan in a partnership.  This bill is entirely contingent upon SEBAC giving their written consent.

The bill creates a SustiNet Health Care Cabinet, and the Comptroller may charge administrative fees and fluctuating reserve fees.

The most disturbing part of House Bill 6308 is Section 12, is that the Department of Public Health will be provided with our hospital and emergency room data with patient identifiable information, which means the information identifies or may reasonably be used to identify an individual patient.  You can be identified by your proper name.  It gets better.  A third party intermediary may be used to submit this personal data. This information shall be kept confidential, that is, until the next laptop is stolen!!!
Read for yourself:
Section 2: The Comptroller shall offer to nonstate public employers and nonprofit employers, and their respective retirees, if applicable, coverage under a partnership plan or plans.
“(h) The Comptroller, in consultation with the Health Care Cost Containment Committee, shall: Develop and implement patient-centered medical homes for the state employee plan ….”
Section 5:  “(b) The Comptroller may charge each employer participating in a partnership plan an administrative fee calculated on a per member per month basis, in accordance with the actuarial standards … In addition, the Comptroller may charge a fluctuating reserves fee the Comptroller deems necessary and in accordance with the actuarial standards … to ensure adequate claims reserves.“
Section 8: “(a) The Comptroller shall not offer coverage under a partnership plan … until the State Employees Bargaining Agent Coalition has provided its written consent to the clerks of both houses of the General Assembly to incorporate the terms of sections 1 to 6, inclusive, of this act into its collective bargaining agreement.”
Section 12: “(1) “Patient-identifiable data” means any information that identifies or may reasonably be used as a basis to identify an individual patient; and
(b) The Office of Health Care Access division of the Department of Public Health shall require each short-term acute care general or children’s hospitals to submit such data, including discharge data, as it deems necessary, hospital shall submit patient identifiable inpatient discharge data and emergency department data to the Office of Health Care Access division of the Department of Public Health to fulfill the responsibilities of the office. Such data shall include data taken from patient medical record abstracts and hospital bills. … The data may be submitted through a contractual arrangement with an intermediary. … Individual patient and physician data identified by proper name or personal identification code submitted pursuant to this section shall be kept confidential, …”
Section 14: “(a) There is established within the office of the Lieutenant Governor, the SustiNet Health Care Cabinet for the purpose of advising the Governor and the Office of Health Reform and Innovation …”

This has everything to do with SEBAC, VOTE NO!!!!

posted by: perturbed | May 30, 2011  1:34pm

perturbed

jonessAC12, you question how this bill is connected to the union agreement. I think DOT Worker has it right—this bill is intimately joined to the state/SEBAC union concession package now being forced upon state employees. Specifically, it looks more and more like the pension and health care benefits of state employees were just bargaining chips used by Dan Livingston, Bob Rinker and company to secure legislative support for their SustiNet bill. Were state workers were betrayed for this bill?

Is it just coincidence that the SustiNet bill is progressing through the legislature exactly when the state/SEBAC agreement, with it’s huge, long-term pension and health care concessions to the Malloy administration, is being forced upon state workers? Even considering that fervent SustiNet supporters were the lead negotiators representing the unions in the deal?

Besides that, the bill will probably end up increasing the cost of the state health care plan.

From the bill:

Sec. 2. (NEW) (Effective July 1, 2011) (a) (1) Notwithstanding the provisions of title 38a of the general statutes, the Comptroller shall offer coverage under the state employee plan to nonstate public employers, municipal-related employers, small employers and nonprofit employers and their respective retirees…

Sec. 3.(a)(2)(C) The Comptroller shall consult with a health care actuary who shall develop actuarial standards to be used to assess the shift in medical risks of an employer’s employees to the state employee plan. The Comptroller shall present such standards to the Health Care Cost Containment Committee for its review and evaluation prior to the use of such standards.

[Sec. 3.(b)(3) and Sec. 4.(b)(3) have similar provisions for estimating the ADDED BURDEN TO THE STATE PLAN.]

Also:

Sec. 8. (NEW) (Effective from passage) The Comptroller shall not offer coverage under the state employee plan pursuant to sections 2 to 5, inclusive, of this act until the State Employees’ Bargaining Agent Coalition has provided its written consent to the clerks of both houses of the General Assembly to incorporate the terms of sections 1 to 6, inclusive, of this act into its collective bargaining agreement.

http://www.cga.ct.gov/asp/cgabillstatus/cgabillstatus.asp?selBillType=Bill&bill_num=6308&which_year=2011&SUBMIT1;.x=0&SUBMIT1;.y=0&SUBMIT1=Normal

—perturbed

posted by: ... | May 30, 2011  7:41pm

...

Just to clarify perturbed, I do understand the potential correlation between the two facts.

My comment was a complain about DrHunterSThompson simply writing ‘Vote No! to concessions’ as his response to the story. No comments on the story itself, no connection (like you have made) between the issues. Just ‘Vote No!’. And an small argument went from there between two users.

posted by: CTisFUBAR | May 31, 2011  7:05am

Enough is enough!  I will be voting NO!