Experts advising the SustiNet board on the future of health care in Connecticut earlier this month said the state program could influence some small businesses to drop their insurance plans, which means their employees could find themselves uninsured and looking for coverage.
That”™s just one of the curiosities of the meeting held on Nov. 18 to talk about several cost scenarios for the eventual SustiNet proposal the board will make to the Legislature. Stan Dorn of The Urban Institute and Jonathan Gruber of MIT presented the scenarios.
Other curiosities include:
How much will it cost ”“ really? The six scenarios were based on unknown levels of insurance benefit coverage. Logically, however, the real cost of any health insurance plan depends on what exactly is being covered and provided. SustiNet co-chairman Kevin Lembo, who is also state health care advocate and comptroller-elect, says someone is working on figuring that out. Shouldn”™t we know that before declaring how much the options will cost, especially during a severe state budget crisis?
Haven”™t things changed? All of the options considered by SustiNet supposedly will save the state money because they are based on getting more federal dollars. That”™s a rosy assumption given the dramatic political change in the nation and specifically in Congress to move away from the federal reforms; and, given the nation”™s severe budget crisis. The House GOP has pledged to begin the process of changing, rolling back or even defunding several aspects of federal health care reform.
What about jobs? Employers in Connecticut are saying uncertainty over federal reforms is one of the reasons why they”™re not adding jobs. Now they face more uncertainty over a state-run plan of unknown cost relying on federal dollars that may or may not materialize, while federal reform could be rolled back and Connecticut has billions in deficits and long-term obligations. That”™s not a confidence-builder nor is the likelihood that a state-run system would undermine the private insurance market in Connecticut which is responsible for tens of thousands of jobs.
Cutting costs or just shifting them? SustiNet board members correctly say that small businesses are struggling with the cost of health care. The board in fact has looked at ways to cut costs, such as the use of the patient-centered medical home concept, electronic medical records and payment reform. But the primary focus should be on actually reducing costs, not changing the health care delivery system. It seems that the aim of SustiNet is to shift more people onto taxpayer-funded plans that compete with the private sector. That”™s not lowering costs, that”™s increasing state spending and, from what earlier projections have found, the state debt.
More is to be done on the issue, and Lt. Gov.-elect Nancy Wyman, who is a SustiNet board co-chairwoman, has said the incoming administration would take a close look at the issue. That”™s a good idea, because while there is desire in some quarters to move this idea forward, there are lots of reasons why it doesn”™t add up.
And Connecticut, especially now, can”™t afford not to know what its financial obligations might be.
Eric George is associate counsel at the Connecticut Business & Industry Association, specializing in health care issues. He can be reached at Eric.George@cbia.com.
