HARTFORD, CT — There are now a handful of bills winding their way through the legislative process that call for a public health insurance option.
But none of them of them go into any detail on exactly what a public option would look like or how it would be structured to compete with private health insurance companies.
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The Insurance and Real Estate Committee raised a public option as a concept Thursday. House Speaker Joe Aresimowicz and Senate President Martin Looney have also introduced legislation.
It was actually former U.S. Sen. Joe Lieberman who killed the idea of a public option during the 2009 debate on the Affordable Care Act. Lieberman, who once supported a Medicare buy-in for those 55 and older, threatened to filibuster the legislation unless the public option was removed.
Gov. Ned Lamont, who ran against Lieberman in 2006, accused him of “dithering” on the issue back in 2009.
On the campaign trail last year, Lamont called creating a universal type healthcare system in Connecticut an “aspirational goal” given the current fiscal situation. He also rejected the idea of an individual mandate “because I just don’t know if the subsidies and protections for people to make it affordable for them are going to be coming out of this Trump administration. So until we know what those subsidies are, until we know what it would cost people, I think I’m gonna have to wait on that.”
But Looney said public option is the next logical step in the healthcare policy debate.
“Creating a public option is a critical and logical policy advancement to provide affordable healthcare for everyone in Connecticut,” Looney said. “Healthcare is a human right, one that I and other Democrats throughout our history have been trying to fulfill. A public option is the next step in our healthcare history from Medicare and Medicaid to Obamacare.”
At one time, Connecticut embraced the idea of a public health insurance option, but the proposal — which pre-dated the Affordable Care Act — was watered down every time a fiscal note was released.
In 2009, Connecticut set into motion the authority for the state to create its own public option when it created the Sustinet board of directors. That board ended up figuring out how to run a state-based exchange, but it never moved forward with a public option.
After a hiatus from the issue, legislative leaders seem more willing this year to push for a the debate on the idea of a public option.
There’s also legislation introduced by Sen. Christine Cohen, D-Guilford, that would allow small employers to join the state employees health insurance plan. There are a number of questions about how exactly that will happen. There are several plans managed by state Comptroller Kevin Lembo that could be used.
“This is an issue that’s a concern around the country. Connecticut really needs to lead on this,” Sen. Matt Lesser, who co-chairs the Insurance and Real Estate Committee, said.
Lesser said small business owners in the legislature, including Cohen and Sen. Alex Bergstein, are leading conversations on the issue.
Lembo, who was Connecticut’s Healthcare Advocate before running for comptroller, said Cohen’s legislation would ultimately lower health care costs for the state by expanding the state’s purchasing power. As a result, Lembo said Connecticut would become a more affordable and attractive place to do business because health care quality will improve and be less expensive for businesses to offer to employees.
“It’s time to provide financial relief to Connecticut businesses and high-quality affordable health care to all working families,” Lembo said.
Rep. Sean Scanlon, the other co-chair of the committee, said it’s an issue they hear about from small business owners all the time.
“It’s a big concern for everyone in the state,” Scanlon said.
Insurance rates in the small group market and individual markets have continued to increase even after the Affordable Care Act went into effect six years ago.
Lesser said the committee will also be looking at what they can do to lower health insurance premiums overall.
“We’re looking at a number of things we can do to make healthcare more affordable overall,” Lesser said.
Sen. Kevin Kelly, the ranking Republican member of the committee, said he’s in favor at exploring ways to lower the cost of insurance, but he said a public option is “problematic.” He asked whether a public option being offered on Connecticut’s exchange would undermine the private insurance companies, who are also some of the state’s largest employers?
“That’s going to put the state of Connecticut in direct competition with its flagship industry,” Kelly said.
The health insurance industry, as they have in the past, will oppose “any march toward single-payer,” Susan Halpin, executive director of the Connecticut Association of Health Plans, said.
Kelly said a public option could impact competition “and destabilize the marketplace.” He said he doesn’t know of any other state that has a public option.
While they disagree on a public option, both parties agree they would like Connecticut to apply for a reinsurance waiver with the federal Centers for Medicaid and Medicare Services.
“Reinsurance looks very different in different states,” Lesser said.
He said that’s why the legislature really needs to be part of the conversation “so we can get a program that works for Connecticut.”
Kelly introduced legislation that calls for the state to apply for a reinsurance waiver “to cover claims for certain health benefits under qualified health plans.”
It’s unclear whether Lamont could apply for a waiver without legislative approval.
