CT legislators roll out proposals to help reduce health care costs
MARK PAZNIOKAS / CTMIRROR.ORG
Rep. Jillian Gilchrest speaks during a debate on the House floor.
Democratic lawmakers, concerned about the high cost of health care and “Trump-era” coverage proposals they say are bad for consumers, unveiled several legislative concepts Tuesday aimed at making health coverage more affordable.
The concepts — which include tax breaks for small businesses purchasing certain policies through the state’s health insurance exchange, an overhaul of Connecticut’s insurance rate review process and expanding the Covered Connecticut program, an initiative offering free coverage to qualifying residents — are expected to be raised during the legislative session that begins Feb. 7.
“People are paying far too much for health care in the state of Connecticut, and far too many Connecticut residents are afraid to seek health care because of the costs, or they’re struggling with excessive medical debt,” said Rep. Jillian Gilchrest, D-West Hartford, a co-chair of the Human Services Committee.
Gilchrest and Reps. Liz Linehan, D-Cheshire, co-chair of the Committee on Children, Christine Conley, D-Groton, Susan Johnson, D-Windham, and Sarah Keitt, D-Fairfield, announced the concepts Tuesday as an alternative to legislation introduced last year that would have allowed for association health plans. Under those plans, established trade associations that meet certain requirements could purchase fully funded health plans from insurance companies on behalf of the group or offer their members self-funded plans, where an employer pays claims directly. The proposal did not pass last year.
“Instead of creating another system that will cause headaches and burdens for folks receiving health care, why not just fix the problems that already exist?” Gilchrest said. “The Biden administration has just proposed a rule that would restrict association health plans, so we don’t think it’s prudent to move in that direction.”
“Going back quite a few years, I’ve been talking to small business owners about the need to make it easier for them to offer health care to their employees,” Linehan added. “Association Health Plans attempted to fill that need with plans rather than self-insured policies, but there were concerns about protecting individual subscribers from high deductible plans and what is known as ‘junk policies.’”
The legislators proposed a tax credit for small businesses that purchase a silver level or higher coverage plan through the exchange, restrictions on the use of stop/loss insurance products, and an expansion of the Covered Connecticut program, which provides free health insurance through the exchange to qualifying individuals and families. Eligibility for Covered Connecticut would increase to include households earning up to 200% of the Federal Poverty Level; the current limit is 175% of the FPL.
“For a family of four in the state of Connecticut, 175% of poverty level is $52,500 a year,” Gilchrest said. Some studies have shown “the annual survival budget to live in Connecticut for that same family of four is $126,018. … We’re not getting to [that full amount], but we are moving in the right direction if we can expand Covered Connecticut to 200%” of FPL.
Legislators are also considering a bill that would limit the size of businesses that can purchase stop/loss insurance and increase the threshold at which employers pay medical claims for workers.
“These plans operate outside the protections of the Affordable Care Act (ACA), penalize companies with employees with higher health needs and destabilize the small group insurance market, while doing nothing to address underlying costs,” they wrote in a summary of the legislative concepts.
And the lawmakers are eyeing overhauls of the state’s rate review process and certificate of need policies. Elected officials, hospital executives and health advocates have called for changes to the certificate of need process, particularly in light of the length of time it has taken the state to issue a decision on a deal for Yale New Haven Health to buy three Connecticut hospitals owned by Prospect Medical Holdings. Several have said the process needs to be expedited. The legislators on Tuesday also called for it to include insurers’ purchases of medical provider practices.
And they recommended amendments to the rate review process, including more rigorous vetting, similar to the procedures that utility rate increases are subject to. Legislative leaders last fall also pressed for changes to the rate review process, including requiring more documentation from the parties involved and more extensive questioning during an annual hearing on proposed rate increases, and considering affordability when approving or denying the rate requests.
Rep. Kerry Wood, D-Rocky Hill, a co-chair of the Insurance and Real Estate Committee, said she was disappointed she wasn’t included in the announcement Tuesday or consulted about the proposals, some of which will likely go through her committee.
“No one communicated with us [on] the insurance committee, nor did they invite us to attend,” she said. “I just found the whole thing very confusing, and I’m disappointed that solutions to help small businesses and nonprofits are not on the table, but there was more spending. Tax cuts are great. I am always supportive of tax cuts, but where’s that money coming from?”
Wood said she is working on a bill that includes limits on stop/loss coverage and pooling plans for nonprofits and small businesses.
Sen. Jorge Cabrera, D-Ansonia, co-chair of the insurance committee, said in a statement that he is open to proposals that would reduce costs for small businesses purchasing health coverage.
“My bottom line is that I want to create more affordable health care for people in Connecticut, with lower premiums, lower deductibles and lower pharmacy costs,” he said. “I’m always willing to look at any proposals that address that.”
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