Until recently seen by some as akin to a moot law in the face of federal health reform, Connecticut”™s SustiNet plan for near-universal coverage has reemerged as a significant legislative battleground.
Under the current proposal, a SustiNet authority would offer seven insurance plans, six of them already existent including the Husky ”“ Healthcare for Uninsured Kids and Youths ”“ plans for impoverished children and their families, the state Medicaid program, the Charter Oak Health Plan formed under former Gov. M. Jodi Rell and the state employee health plan.
A new plan would be created for small businesses, nonprofits and public employers not part of the state such as municipalities. And the state would establish a basic health plan for families with income between 133 percent and 200 percent of the federal poverty level, while shifting some of those costs to the federal government.
Democrats pushing for a full SustiNet implementation do not have an ally in Gov. Dannel P. Malloy, who likes SustiNet”™s aims but says the state”™s budget crisis will not allow for a major program that threatens to balloon the deficit further.
“The vision for SustiNet ”¦ is expansive, bold and ambitious, but boldness and ambition are not enough,” agreed Stephen Frayne, senior vice president of health policy for the Connecticut Hospital Association, testifying on the bill in Hartford. “To be successful, a vision has to be matched with ability and sufficient resources. The proposal does not provide sufficient resources.”
The debate pits hospitals, business groups, insurance carriers and physician groups against consumer advocates and at least one group representing small businesses, all fed up with skyrocketing health insurance rates and the ripple effect it is causing in quality of service.
Since mid-February, some 150 organizations and individuals have filed testimony on the bill, including Small Business for a Healthy Connecticut. Member Brenda Cerezo has operated a beauty salon in Stamford for the past 14 years ”“ in testimony to the Connecticut General Assembly, she said she cannot afford health insurance for herself or her three employees.
“I”™d like to keep them, but the unpredictable and high cost of health insurance makes me nervous and unsure of my ability to keep paying for the benefit,” Cerezo said.
Richard Mackowiak, a self-employed hydroelectric engineer in the Windham County town of Eastford, said he pays about $19,000 annually for health insurance for his family of three, accompanied by a $5,000 deductible.
“We continually apply for new, more-affordable coverage but are denied for pre-existing conditions,” Mackowiak testified. “For example, I was denied coverage for a condition called Raynaud”™s (disease). In 2006 I told my doctor that my fingers seem to get cold easily during cold weather; my doctor said it could be Raynaud”™s (which) relates to circulation. He did not prescribe any treatment, so now I am denied health insurance because my fingers get cold in winter.”
The Connecticut Association of Health Plans hinted enacting SustiNet could be taken as a broadside against the industry.
“There are approximately 70,000 people in our state employed directly or indirectly in the health insurance industry,” the association testified. “SustiNet dismisses this essential part of our jobs infrastructure and sends precisely the wrong message to health insurers located here: We don”™t want you and we don”™t need you.”
Four physician groups meanwhile are protesting a legislative committee”™s decision to remove medical liability protection from SustiNet.
“Removing the ”˜safe harbor”™ for physicians who participate in SustiNet is an incredible barrier to having primary-care physicians participate,” said Dr. Robert McLean, governor of the American College of Physicians in Connecticut, in a prepared statement. “Without an adequate supply of physicians willing to see this expanded pool of patients, our patients are the ones who will suffer.”
