It is hard to know where to start when talking about the benefits for Connecticut in the historic health care reform passed last week by Congress. To begin, 343,000 uninsured Connecticut residents will have access to decent coverage. That alone would make the struggle for passage worthwhile.
But there’s more. With subsidies for people at lower income levels and other reforms, coverage should be more affordable for everyone. A new exchange will make buying insurance rational and understandable preventing consumers from being deceived by slick marketing into buying insurance that won’t cover what they need. New insurance regulations will also make coverage meaningful, including provisions such as not allowing denials for pre-existing conditions or caps on lifetime coverage. Seniors who pay for insurance and prescription drug coverage will no longer face the Medicare donut hole where they get no prescription coverage but continue paying premiums to insurance companies.
But wait, there’s more. Employers and workers will see benefits as well. The two thirds of the state’s employers who do the right thing and offer benefits to their workers will no longer be at a competitive disadvantage; those who don’t will have to shoulder some of the burden. With benefit costs more affordable more small businesses will be able to hire. And conversely, employees who are locked into jobs solely for health benefits will be able to move on to new jobs or careers and help grow our economy.
The bill is not perfect. We will need to make changes. Critics say the legislation includes too many pilot programs and not enough big changes. But we need trial programs. We don’t really know what saves money. In the past we’ve wasted time trying high deductible plans, health savings accounts, increasing co-pays, limits on drugs and treatments, ratcheting down payments to providers – and costs stubbornly continued to skyrocket. The pilot programs offer an opportunity to try new things such as paying for better quality; establishing “medical homes” for people that emphasize prevention ; paying providers fair Medicaid rates so they don’t have to shift those costs onto the rest of us.
It is unfortunate that the final bill does not include a public option. However, Connecticut’s, state legislators created a safety net in SustiNet, a program to provide health care to uninsured and small businesses. There are eight SustiNet working groups hard at work designing a rational health care system including building the state’s health care workforce, implementing information technology, and improving the quality of health care.
Today, no one can accurately predict what health care reform will cost or save us in the long term. Many of the provisions aren’t effective until 2014 or later. We cannot know how much health care will cost for patients, employers and taxpayers by then or how many state residents will still be uninsured.
In terms of savings, we do know that the state is likely to save at least the $100 million-plus spent on the State Administered General Assistance and Charter Oak programs. Also, with fewer uninsured, fewer patients will delay care until problems are so serious they are forced into emergency rooms with problems that are more difficult and costly to treat, saving us all.
It has been a long and difficult fight to get to this day, but the legislation approved by Congress is an exceptional piece of good fortune for Connecticut and we should be deeply grateful to our members of Congress and to the President. The naysayers are simply wrong.
Ellen Andrews is the executive director of the Connecticut Health Policy Project.