Image of health insurance concept. (Designer 491 via Shutterstock)
(Designer 491 via Shutterstock) Credit: Designer 491 / Shutterstock

For small business owners like Deb Dauphinais, co-owner, Bicycles East, Glastonbury, there are few options for health insurance and none that is truly affordable. 

“There is a gap in the system for small businesses,” Dauphinais said. “You can’t buy into these bigger plans right now and we don’t qualify for any subsidies.” 

That means Dauphinais and her husband pay 20 to 30% of their take-home income for health care. She said about 15% of that is premium alone. The plans also have high deductibles. 

That’s why she was hoping state Comptroller Kevin Lembo’s proposal to create a state-run insurance option for small businesses and nonprofits would pass this year. 

It’s also why Dauphinais and Rev. Josh Pawelek sent a letter to lawmakers asking them to “Show Us the Fix.” 

“We challenge you to go through the same process we do every year, and find us a plan that you would regard as affordable, considering both premiums and out of pocket expenses,” Dauphinais and Pawelek wrote. “Most importantly, find us a plan that you would personally regard as quality health insurance for you and your family.” 

Pawelek, a minister at the Unitarian Universalist Society: East, Manchester, said 10% of their operating budget goes to paying for health insurance for three of their five employees. Two others have coverage through their spouses. 

Pawelek said when the plan they had increased costs by 17% they were left trying to find another plan that would only increase 10% because that’s what they assumed when they put together their budget. 

He said the death of the public option was “infuriating,” because it meant going another year without solving the problem. 

Pawelek said Rep. Kerry Wood, who co-chairs the Insurance and Real Estate Committee, has been the only lawmaker to respond so far to their challenge. 

Wood said last week that she didn’t feel it was necessary to move forward “with another government program that has a cost when we have all this money coming into the exchange.” 

Through the American Rescue Plan, the federal government gave Connecticut $85 million over the next two years to lower health insurance premiums for individuals who purchase their plans on the exchange. 

However, those subsidies don’t necessarily trickle down to small businesses. Pawelek said he will be meeting with someone at Access Health CT to go over their options. But he said, regardless, it’s a federal program and the state is still not doing enough to help small businesses. 

“Small business is the backbone of the community, of the economy,” Dauphinais said. “Not only are we paying ridiculously high amounts of money, and we’re also subsidizing a large portion of health care for our employees that they don’t use either. The system is broken.”

Wood said they will be diving into the $85 million in federal subsidies to find out where the holes are and where the state of Connecticut can help. She said there’s still no mechanism to lower the cost of health care, which is driving some rates upward.

“We need to do a deep dive,” Wood said. “Including into the small group market.” 

She said over the next two years lawmakers need to be looking at lowering the cost of care. 

Wood said she doesn’t believe Lembo’s proposal was going to lower health insurance premiums and was concerned that the taxpayers would have had to be the backstop if the claims exceeded the premiums. 

Pawelek said that’s because Wood and her committee changed the bill to require Lembo to follow all the same rules as fully-insured plans sold by private insurance companies. He said they were hoping to loosen some of those rules and save money as a result. 

The health insurance industry fought hard against the public option saying it would jeopardize more than 48,000 jobs in the industry and $15.5 billion in direct or indirect economic activity.

Two weeks ago, lawmakers who are dealing with the governor’s office on legislation say Gov. Ned Lamont essentially made it known he would not support the so-called public option. 

“This is a missed opportunity that will have real-life consequences for the small employers in our state that have been pleading for help after taking a massive economic hit from the pandemic,” Lembo said. “To cast them aside is both a terrible message to send and a severe economic miscalculation.” 

Lembo credited the health insurance industry for their lobbying and advertising efforts against the legislation as one of the reasons for its impending death. 

“The governor and legislature agree health care is a human right that too many Connecticut families struggle to afford,” Paul Mounds, Lamont’s chief of staff, said. “The governor is confident we can work across branches and across the aisle to lower the cost of prescription drugs, take full advantage of transformative federal investments, and make coverage more affordable and attainable for as many residents as possible.“