Rx for health coverage proves illusive

Between snake-oil pitches and more substantive remedies for what ails Connecticut”™s health-care system, Gov. M. Jodi Rell and state Democrats left the patient languishing on the legislative gurney right up to a cliffhanger ending worthy of Grey”™s Anatomy.

Before the legislative session opened in January, Rell promoted her Charter Oak Health Plan as a way to negotiate pricing with carriers to get uninsured residents onto their plans. Democrats touted their own Healthfirst Connecticut initiative in the first bill proposed in the 2007 session, with state Senate President Donald Williams terming the state system “on life support.”

In the waning days of the session, Rell stumped for legislation to lower energy prices, but was largely quiet on health insurance premiums, which the Connecticut Business and Industry Association (CBIA) has identified as perhaps the thorniest problem confronting small businesses.

Under Rell”™s Charter Oak plan, the state would negotiate with insurers to establish insurance pools for those lacking health insurance, with some premiums as low as $250 a month.  Rell also would waive insurance premiums for newborn children of eligible families, hoping to get families onto the state”™s existing Health Care for Uninsured Kids and Youth (HUSKY) program.

The Democrats”™ HealthFirst Connecticut plan is designed to expand HUSKY to cover an additional 140,000 people. HealthFirst would do so by:

 

? raising income eligibility limits;

? allowing unmarried and childless people to remain on their parents”™ insurance plan until they turn 30;

? improving outreach via schools;

? eliminating bureaucratic bottlenecks in enrollment; and

? increasing reimbursement for medical providers to put rates on par with Medicaid.

 

HealthFirst Connecticut would also require employers to deduct health-care premiums from employee salaries on a pretax basis.

“The reason health care has broken down in the state of Connecticut ”¦ is because we pay 30 percent below Medicare rates,” said state Rep. Jason Bartlett of Bethel. “If we do not address those rates, we”™ll continue to have denial of access for folks, which will continue to drive up costs.”

Four participating insurers commissioned a Falls Church, Va., health-care consultant called The Lewin Group to assess the HUSKY program. The firm found that since its establishment more than a decade ago, HUSKY has outperformed many similar plans in other states, but the firm agreed that the state should sharply increase payouts.

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As of December, 309,000 Connecticut residents were enrolled in HUSKY, about 9 percent of the states estimated population. Anthem Blue Cross Blue Shield covered more than four in 10 people enrolled in Husky, with the remainder split between Community Health Network of Connecticut; HealthNet of the Northeast; and Wellcare of Connecticut.

While the governor and the Connecticut General Assembly adopted differing routes to the same goal ”“ reducing expenses by ensuring insurance for all residents ”“ a more radical experiment in Massachusetts is demonstrating that is no easy road.

With a July 1 deadline looming for Bay State residents and businesses to obtain health insurance, Massachusetts policymakers indicated at the current pace many will fail to do so. Unlike the Connecticut plans under consideration, businesses and residents in Massachusetts can be hit with financial penalties, although policymakers have stated that those who sign up in the second half of the year likely will not be penalized.

Besides Charter Oak and HealthFirst Connecticut, several other health-related plans were floated in the 2007 session.

State Sen. Joe Crisco proposed creating a Nutmeg Health Partnership Insurance Plan, which would establish tax credits for some small companies that provide their employees health insurance three years running, and would add a new classification for insurers to use in developing rates for small companies.

The proposed Connecticut Saves Health Care program, supported by labor unions, would create a single-payer system to streamline the claims process, which opponents say would drive insurance carriers out of the state.

The Connecticut Healthy Steps program would establish health savings account incentives and other premium subsidies, while creating various health-care boards.

In early June, the Connecticut Senate passed a bill that could escalate health-related costs for businesses. By a 21-15 vote, the Senate approved legislation that would give workers”™ compensation commissioners more leeway in awarding discretionary payments to injured workers, in addition to compensation for lost wages.

According to the National Council on Compensation Insurance, workers”™ compensation costs would rise between 25 percent and 55 percent. The bill would provide an incentive for injured workers not to return to work in order to secure higher discretionary benefits, according to CBIA assistant counsel Kia Floyd.