

Commercial health insurance premiums in Connecticut are the sixth highest in the nation and they continue to grow faster than inflation. While we’re making progress, it’s too slow. Legislators heard this loud and clear from voters during the last campaign. A public health insurance option to compete with private plans is getting a lot of attention from legislators and it makes sense conceptually.
In 2010, our nonprofit CT Health Policy Project signed up with the Comptroller’s office to cover our staff through MEHIP, Connecticut’s first iteration of a public option. It seemed to make sense and we wanted to do the right thing. Unfortunately, it became too expensive and we moved to a private option the next year. Since then, the state has tried other versions of a public option; they’ve all disappointed for varying reasons.
Connecticut consumers deserve a robust public option that is affordable and sustainable into the future. We need one that provides high-quality care, with stellar member satisfaction rates, one that providers want to participate in, and doesn’t save money by shifting costs onto consumers or taxpayers. There are important improvements to the current proposal that would bring the public option closer to that goal.

Nonprofit directors and small business owners choosing between plans should be able to compare the quality of the public option with private plans already available. The state health insurance Consumer Report Card compares private plans offered in Connecticut on dozens of quality metrics including how many pregnant women get early prenatal care, how well they help people control their high blood pressure, and member satisfaction rates. It also includes the number of providers participating in the plan by specialty and county, member satisfaction levels, claim denial rates, complaints, access to mental health and substance use treatment, and how much of premiums are spent on health care versus administration. The new public option should be included in the Consumer Report Card for an apples-to-apples comparison.
There are serious concerns about the state’s liability for a public option if premiums do not keep up with health care costs. Private insurance is backed by large insurers, banks and Wall Street. But a public option is backed by the state – meaning the liability falls on taxpayers as well as schoolchildren, nursing home residents, people with disabilities and others who rely on state services.
The latest iteration of the public option, the Partnership Plan 2.0, is losing money. Another public option attempt, Connecticut’s Charter Oak Plan, ended in a death spiral for this reason. Artificially keeping premiums lower than health care claims helps the municipalities that participate, but it costs taxpayers millions and the price tag is growing. In uncertain times, it would be tragic if keeping the public option solvent caused cuts in efficient, proven coverage programs like HUSKY.
It is very hard to get any fiscal information on the Partnership Plan or on the much larger state employee health plan. Complete public financial reporting should be required of any public option plan. Taxpayers have a right to know how much it is costing us and what the trade-offs are.
The public option should live by the same rules that govern private insurance. Under the Affordable Care Act, insurers have to offer coverage to anyone who applies, regardless of preexisting conditions. The current public option plan is allowed to cherry-pick members with fewer health problems to keep the pool solvent. This leaves the exact people suffering now for lack of an affordable option out of luck. People with more health care needs will have to stay in the private plans, raising private premiums even higher.
The public option should allow groups to leave at the end of a year, without a penalty, as for private plans. Small businesses and nonprofits can’t afford to be locked into a plan for three years without knowing the costs. My nonprofit board wouldn’t let me sign a contract like that.
All these provisions must be included in legislation, so they apply to future comptrollers and administrations. Changes should not be made behind closed doors but should follow a transparent legislative process with public input.
Support authentic, locally owned and operated public service journalism!
A good public option could make Connecticut’s insurance market more competitive and help keep costs down, but it won’t work alone. We have to address the input costs that are driving up all health care spending. Prices for drugs and services at huge health systems are to blame. Both lack effective competition to keep prices reasonable. Addressing those will have a meaningful, lasting impact on affordability. But the ongoing controversy over a public option is taking all the oxygen out of the room. We should try everything, including the best possible version of a public health insurance option.

Ellen Andrews, PhD, is the executive director of the CT Health Policy Project. Follow her on Twitter @CTHealthNotes.
The views, opinions, positions, or strategies expressed by the author are theirs alone, and do not necessarily reflect the views, opinions, or positions of CTNewsJunkie.com.
More from Ellen Andrews

OP-ED | Policymakers Did Little to Lower Healthcare Costs This Session
Last year, Connecticut policymakers accomplished little to reduce the cost of healthcare, and those costs haven’t gotten any better since then. Incumbents will be asked what they did this year to provide some relief. Unfortunately, they have little to offer.
Keep reading
ANALYSIS | Fact Check Shows That Raising Primary Care Spending Doesn’t Lower Total Healthcare Costs
Ellen Andrews checks the facts on HB 5042 and says it’s very appealing to think that increasing investments in prevention and care management will reduce total healthcare costs. It avoids the difficult work of getting large health systems and drug companies to lower their extreme prices. But unfortunately, she says there is no evidence to…
Keep reading
OP-ED | Children Deserve Healthcare, Regardless of Immigration Status
Last year, Connecticut policymakers made the smart and moral decision to provide HUSKY coverage to children from low-income families through age eight, regardless of immigration status, starting next year … but it makes more sense to cover all children.
Keep reading
Connecticut Officials Tackle Drug Pricing
The cost of prescription drugs is increasing, and Gov. Ned Lamont and some lawmakers are renewing their push to lower the cost by telling companies how much they can charge. “A survey in 2018 found that 20 percent of people of Connecticut residents were either cutting pills or skipping prescriptions because they couldn’t afford it,”…
Keep reading
OP-ED | Class Action Against Hartford Healthcare Changes the Landscape
Ellen Andrews says the new lawsuit filed last week by six brave Connecticut residents alleges that Hartford Healthcare is manipulating the market to drive out competition and raise prices.
Keep reading
OP-ED | The Governor’s Plan To Lower Healthcare Costs – What’s In It, And What’s Missing
Ellen Andrews highlights the good, the bad, and the ugly in Gov. Ned Lamont’s legislative package on healthcare.
Keep reading
OP-ED | How Much Do CT Hospitals Spend On Administration? No One Knows
Ellen Andrews tried to figure what the state knows about how hospitals spend their money. As they grow & charge more, do they improve patient care or just hire more administrators? We don’t know. But we should.
Keep reading
OP-ED | Connecticut’s Healthcare Market Regulation Is Broken
Healthcare consolidations are endangering access to care and driving up prices. But the state agency that is supposed to keep Connecticut’s healthcare market competitive isn’t acting.
Keep reading
OP-ED | The Brainard Fund Still Making A Difference After 64 Years
In 2010, I got a call that advocates only dream about.
Keep reading
OP-ED | It’s A Miracle – Under New Agreement, Medicare Will Negotiate Drug Prices
Democrats in Washington have negotiated a deal to allow Medicare to negotiate prices with drug companies. Americans pay 2.56 times higher drug prices than residents of other developed countries. Ellen Andrews says that politically, this is a seismic shift.
Keep readingMore Health Care News & Analysis

6 Common Barriers Men Face When Seeking Mental Health Support
The outward effects of mental illness can often be dismissed as a sign of weakness or personal failure. For men, this type of social stereotyping can be especially hard to escape — being told to “man up” is a common refrain that can be reductive and stigmatizing.
Keep readingMedical Examining Board Fines Doctor $10,000
The state Medical Examining Board on Tuesday fined an Oxford doctor $10,000 for fraudulently using another doctor’s name and Drug Enforcement Agency registration number to prescribe controlled substances to a family member.
Keep reading
Clinical Trials With Immunotherapy Drugs Are Source Of Hope And Challenges In Treating Aggressive Breast Cancer
Joshalyn Mills of Branford and Nancy Witz of Kensington had the best possible results after being treated in clinical trials with immunotherapy drugs for aggressive breast cancer: Their tumors were eliminated. But while there are dramatic successes with immunotherapy drugs, there are also many failures, and researchers are trying to find out why in hopes…
Keep reading
Coalition of Health Insurers Questions Viability of Connecticut Partnership Plan
Members of Connecticut’s Health Care Future, a coalition of health insurers, hospitals, and businesses, are questioning whether Connecticut lawmakers have done enough this year to protect teachers and municipal employees from increases in health insurance premiums. “Despite repeated bailouts from taxpayers, the Connecticut Partnership Plan continues to be a fiscal Titanic that demonstrates why government-controlled health…
Keep reading
AG’s Tackle Mental Health Parity
Attorneys General in Connecticut and Rhode Island threw their support Monday behind a coalition of mental health advocacy groups asking a federal appeals court to revisit a recent ruling giving insurance companies more flexibility to deny mental health claims.
Keep reading
Budget Green Lights Psychedelic Therapies
Buried in the budget Gov. Ned Lamont signed this week is a provision that would create a pilot program to allow Connecticut to be the first-in-the-nation to study the impact of psychedelic drugs like psilocybin and MDMA on patients with depression and PTSD. The budget now creates a pilot program within the Department of Mental…
Keep reading