A legislative commission has proposed subsidizing premium payments for workers who cannot afford their employer”™s health insurance plans, while adjusting several prominent state-financed insurance programs for eligibility under the federal Medicaid program.
Formed by the Connecticut General Assembly in 2007, the HealthFirst Connecticut Authority published its aims in mid-December, outlining eight broad policy goals as well as specific program recommendations.
The proposals are part of a 100-page proposal for guaranteeing access to affordable insurance for all residents ”“ a goal the HealthFirst panel acknowledged the state may not be able to afford itself at present, due to upfront costs needed to get the state on the path toward long-term savings.
Perhaps the most radical proposals involve applying to the Centers for Medicaid and Medicare Services (CMS) to convert three state plans for at least partial eligibility under the Medicaid program: the nascent Charter Oak Health Plan that debuted last year to provide low-cost insurance for people unable to afford it; the Husky A plan for parents; and the State-Administered General Assistance (SAGA) plan that covers childless adults below the federal poverty limit.
“This report is neither a blueprint nor an end,” said Tom Swan and Margaret Flinter, co-chairs of the HealthFirst Connecticut Authority, in introductory remarks to the document. “The 2009 General Assembly will take up the recommendations in session. Others ”¦ will also be bringing forward comprehensive recommendations for health reform. There will be a lot of further discussion and this is good. If solving (health care) was easy, someone would have done it long before we came along.”
For projects deemed too expensive in the short term, the panel recommended where possible funding should be freed for pilot programs to test their worth as the federal government undertakes a similar examination of national health systems.
“The state needs to be ”˜shovel ready”™ when new opportunities are presented,” the panel stated, using a pet phrase of Gov. M. Jodi Rell for construction projects that might qualify for federal funding.
HealthFirst recommended the state create a new entity to implement changes, consisting of a five-person board appointed by the governor and legislature, and with several existing agencies providing additional nonvoting board seats, including the state comptroller and the heads of the departments of health and social services.
For eligible residents who are offered employer-based insurance but cannot afford it, the state would develop programs to allow employers to assist their workers to buy into the relevant public program, equal to what the employer contributes for its other employees.
Alternatively, the state would assist workers in meeting the employee contribution to the employer”™s insurance plan, with the sum equal to what the state would pay if the individual enrolled in a state program, consistent with the affordability principles.
Under the HealthFirst plan, individuals who opt out of either a public or private health insurance plan could face penalties upon any reapplication, which officials hope would encourage people to obtain and retain insurance. It is the closest thing to a stick in the plan; Massachusetts has law that penalizes individuals and small employers at tax time if they are not insured.
The plan also attempts to resuscitate the Connecticut Health Partnership, vetoed by Rell last year, which would open the health insurance pool for state employees to workers in small businesses, nonprofits and municipalities. In theory, the plan would limit the impact a single individual with health woes in a small business could have on the premiums of fellow employees; Rell vetoed the bill last year on concerns it could inflate the premiums paid by the state for public employees, while hinting she might be amenable to a similar version of the plan with unspecified adjustments.
The Connecticut Business & Industry Association, which has a for-profit affiliate that sells health insurance, opposes that plan.
