Christine Stuart photo

Will Congress pass a set of sweeping health care reforms by Oct. 15?

Jonathan Gruber, an MIT professor recently appointed to serve as a health adviser to the Congressional Budget Office, said he expects the health care debate on Capitol Hill to pick up speed this summer.

“If they find the money they get it done. If they don’t find the money they won’t get it done,” Gruber said during a conference call organized by the Universal Health Care Foundation.

That’s the $150 billion question, he said.

Gruber, who was one of the consultants hired by the Universal Health Care Foundation to help create the SustiNet proposal, said if the legislature passes the SustiNet proposal it will be in a better position to receive those federal dollars. He said Connecticut is the second furthest of any state in the nation in the health care debate and can play a critical role in the national debate.

Prior to the conference call Wednesday, Gruber made a presentation to the Health First Authority, created by the legislature in 2007 to study access to care and health insurance coverage.

During his presentation Gruber said he’s convinced an individual mandate to purchase health insurance is a meaningful option, but it’s not one included in the SustiNet proposal.

Proponents say SustiNet improves the delivery of health care and gives all state residents access to affordable health care by using the purchasing power of a massive health insurance pool.

Frances Padilla, vice president of the Universal Health Care Foundation, asked Gruber whether employers in Massachusetts starting dropping their employer-sponsored health insurance once the individual mandate was in place.

Gruber said without the individual mandate there was a large erosion in employer-sponsored insurance. He said since Massachusetts implemented the mandate there’s actually about 50,000 more people on employer-sponsored plans.

“Reform without a mandate is worse than what we have today,” Gruber said much to the chagrin of some in the room.

“Massachusetts must be some magical place,” Ellen Andrews, executive director of the Connecticut Health Policy Project, said.
As a patient advocate, Andrews said she doesn’t believe an individual mandate in Connecticut would be as effective as it was in Massachusetts because consumers in Connecticut lack the protection they need. She said that’s why the Office of Health Care Advocate was so desperately needed in Connecticut.

She said even with an individual mandate there’s indication that consumers would get their monies worth and actually get what they pay for. “Connecticut is not Massachusetts,” Andrews concluded.

Tom Swan, co-chairman of the Health First Authority, said he would prefer to see an automatic enrollment financed by progressive taxation. In an automatic enrollment individuals would have to default out of the plan.

At the end of the day, Swan felt Gruber had an “unrealistic expectation of what working families face,” when they are forced to purchase health insurance and add another expense to their family budget.

Gruber conceded Wednesday afternoon that the goal in Massachusetts was to get everyone covered, while the goal in Connecticut is to get everyone covered and lower costs. “It’s a lot bigger challenge then what we did in Massachusetts,” he said.

He said with the combination of things laid out in the SustiNet proposal he thinks Connecticut will come close to getting everyone covered and lowering costs.

Juan Figueroa, president of the Universal Health Care Foundation, said under the SustiNet proposal 98 percent of Connecticut residents would have coverage by 2014. He said the bill was just voted out of the Labor and Public Employees Committee today.

He said over the next few weeks he expects a few more committees to pass the SustiNet bill before it reaches the floor of the House for a debate.