The Connecticut Partnership Plan, which is the health insurance plan that serves nearly 60,000 teachers, police officers, firefighters, and other municipal employees, paid out more in claims than it collected in premiums in 2022.
According to the annual report produced by state Comptroller Sean Scanlon’s office, in 2022 the state collected $622 million in premiums, but paid out $659 million in claims. Independent actuaries are not projecting the plan to get much better for 2023, but uncertainty abounds.
In 2022, it means for every $1 collected in premiums, $1.06 was expended on medical and pharmacy claims.
“FY23 projections remain uncertain due to the potential impacts of inflation on the health care industry,” the report reads.
The report goes onto read: “While unfortunate, this loss does not indicate long-term challenges to the financial stability of the Partnership Plan. Moreover, higher than projected claims costs were an issue faced by many health plans across the state and nation.”
In a press release, Scanlon blamed the pandemic.
“Predictability in the post-COVID healthcare market continues to be challenging. However, the Comptroller’s Office will monitor and report on costs from Partnership Plan enrollees versus State Health plan enrollees to ensure the long-term strength and sustainability of the program,” Scanlon said.
The Partnership Plan was expected to be the basis for the public option that was supposed to compete with private insurance plans. However, legislation calling for it failed to gain traction over the past few years for fear that taxpayers would have to pick up the slack even though it was promised that stop gap insurance would be purchased as protection.
“Comptroller Scanlon supports the concept of a public option, but his main focus this session is working with the Governor and legislature to advance other solutions that increase access and lower costs,” Scanlon’s spokesperson said.
Scanlon’s predecessor, Kevin Lembo, was the main proponent of a public option before leaving office to deal with a serious health condition.
“In the event that the Partnership Plan experiences financial challenges in the future, the annual report provides possible policy solutions for consideration, including changes to allow adjustments for plan cost differentials, creating additional premium tiers, and allowing the comptroller to set independent reserve fund adjustments for the Partnership and State Plans,” the press release reads. “These policy options, if adopted, would maintain the core elements of the Partnership Plan while promoting fiscal stability and thoughtful oversight.”
Scanlon added: “The first responders, teachers and plow drivers who go to work each day to provide essential services to Connecticut’s communities deserve affordable and quality health care, and they can get it through the Partnership Plan. I look forward to working with municipal government leaders to improve this invaluable option in the future.”
The future of the Partnership Plan seems rocky, according to the annual report.
“The real risk to the long-term financial stability of the Partnership Plan is if the Partnership Plan’s per member health care costs are consistently higher than those of the State Plan after regional cost adjustments are applied,” the report reads. “Should this occur, the Partnership Plan premiums, as applied under current statute, would be consistently too low to cover the plan’s costs.”
Scanlon said in the press release that his office will keep monitoring the situation to determine whether legislative intervention is necessary.