Health Care Expansions Since 1993

OLR Research Report


January 3, 2002		2002-R-0009
HEALTH CARE EXPANSIONS SINCE 1993
By: Robin Cohen, Principal Analyst

You asked us to summarize all of the legislative affordable health care coverage expansions proposed (at least a public hearing and fully drafted) or enacted since 1993. You are interested only in initiatives that would increase the number of people for whom affordable coverage is accessible, versus expansions in the types of services insurers would be required to cover.

Since 1993, the legislature has passed a number of bills (18), and considered several others (23), that would improve access to affordable health insurance coverage. Several enactments have made it easier for children to get coverage, either through expansions in traditional Medicaid, or through the creation of new programs, such as HUSKY and Healthy Steps. Others have offered state employee health care coverage to a number of entities, such as small businesses and nonprofit organizations. And still a few others have provided tax breaks to employers who subsidize all or a portion of their employees' health care costs.

Table 1 summarizes, by year, both the enactments and bills that were heard and fully drafted, but failed to pass.

Table 1: Health Care Expansions-Enactments and Proposals-1993-2001

*Year*	*Bill/PA #*	*Summary*	*Status*
1993	HB 7022/PA 289 (codified at CGS § 17-134b)	Expanded Medicaid coverage for children between ages one and six from 133% to 185% of federal poverty level (FPL).
	SB1015/PA 137 (codified at CGS Sec. 38a-564, et. seq. )	Allowed insurance carriers to offer special health care plans to small employers and reduced, from two years to one, the time employers must be without insurance coverage to qualify for these plans.
	HB 6964/ PA 429 (codified at CGS § 5-259(a))	Made employees of the CT Institute for Municipal Studies eligible for the state employee health insurance plan.
	SB 1009	Permitted self-employers to group together for the purpose of purchasing group health insurance coverage.	Died in Insurance
1994	HB 6005/PA 5, MSS, (codified at 17-134b)	Expanded Medicaid coverage to children born after September 30, 1983 (family income up to 185% of FPL).
	HB 5680/PA 216 (codified at CGS § 5-259(f))	Allowed dependents of DCF-designated foster parents and parents in permanent family residences to be covered under the state health insurance plan.
1995	HB 6132/PA 205 (codified at CGS § 19a-7c))	Expanded the Healthy Steps program (public-private child health insurance coverage for non-Medicaid-eligible) by changing the maximum age for eligibility from 13 to 17 years.
	SB 42/PA 269 (codified at CGS § 17b-255)	Made permanent the insurance assistance program for people with AIDS
	HB 6400	Permitted the comptroller to arrange and procure group dental and health insurance plans for state small businesses and allowed for establishment of oversight boards.	Died in Public Health.
	HB 5281	Required group and individual coverage for adopted children.	Died in Insurance.
	HB 6130	"Health Care Authority Act" required the development and implementation of a "single-payer" plan to enroll all residents in certified health plans by January 1, 1998.	Died in Public Health.

Table 1: (Continued)

*Year*	*Bill/PA #*	*Summary*	*Status*
1996	HB 5645/PA 234 (codified at CGS § 5-259(i))	Allowed municipalities and their employees to participate in the state employee health plan. Required municipalities to negotiate with unions over whether to participate. Extended same coverage to county sheriff-appointed deputies and special deputies.
1997	HB 8601/PA 2, October 29 SS (codified at CGS § 17b-289, et seq. )	Established HUSKY program.
	HB 8003/PA 2, June 18 SS (codified at CGS § 17b-261, 17b-257, and CGS § 5-259(e)).	Extended Medicaid child coverage to 17-, 18-, and 19-year-olds and offered state-funded health care coverage to certain aliens ineligible for Medicaid. Required Board of Education and Services for the Blind to pay health care costs for sheltered workshop employees with its own funds instead of employees' earnings.
	HB 6266/PA 268 (codified at CGS § 38a-538, -554, et seq. )	Provided employees and their dependents who lost state comprehensive health coverage the same length of continued coverage as provided under the Comprehensive Omnibus Reconciliation Act of 1985 (COBRA).
	HB 5883	Expanded municipalities' and public agencies' authority to jointly self-insure or buy insurance.	Died on House calendar.
	HB 6662	Provided time-limited, ongoing health insurance benefits for surviving spouses and dependents of public safety employees.	Died in Labor.
	HB 6666	Directed the state comptroller to study the feasibility of the state offering its health plan to small businesses, self-employed individuals, and certain others. Study to include purchasing pool option.	Died in Legislative Management.
	HB 6703	Required the comptroller to offer certain licensed family day care providers and their dependents health care coverage, either through separate group procurement or through the existing state plan.	Died in Insurance.

Table 1: (Continued)

*Year*	*Bill/PA #*	*Summary*	*Status*
	SB 1314	Required the state to increase the income limit for child Medicaid from 185% to 250% of the FPL. Offered tax credits to small businesses equaling 25% of what they spent on employees' "affordable" health insurance coverage.	Died in Appropriations.
	SB 452	Extended continued group comprehensive health care coverage from the end of the month following a divorce, annulment, or legal separation to 18 months after such actions.	Died on House calendar.
	SB 1209	Eliminated the three-year limit on continuing coverage that employers' group comprehensive plans had to provide to dependents of deceased employees.	Died in Insurance.
1998	HB 5628	(1) Extended HUSKY B eligibility to 20-year olds; (2) required Medicaid coverage for certain children ineligible for HUSKY B; and (3) directed the comptroller to study the feasibility of offering the state employee health insurance plan to a number of groups, including small businesses and nonprofits.	Died in Appropriations.
	SB 502	Required the comptroller to study the feasibility of offering the state health insurance plan to residents whose COBRA premiums were higher than their recommended monthly expenditures.	Died in Labor.
1999	HB 7104/PA 279 (codified at CGS § 17b-261)	Provided Medicaid coverage to parents and caretaker relatives of children enrolled in Medicaid.
	SB 1289/ PA 124 (codified at CGS § 5-259(i) and (m))	Allowed the comptroller to include community action agency employees in the state employee health insurance plan. It also exempted municipalities that obtained insurance through the state plan from the small employer law.
	HB 5990	Allowed workers over age 50 who had been "downsized" and had exhausted COBRA coverage to buy into the state health insurance plan.	Died in Appropriations.

Table 1: (Continued)

*Year*	*Bill/PA #*	*Summary*	*Status*
	SB 1293	Permitted the comptroller to include self-employed people in the state employee health insurance plan. Required the Department of Social Services (DSS) to give those with incomes up to 300% of the poverty level the option to participate in HUSKY.	Died in Insurance.
	HB 5722	Required the Labor Department to assess uncompensated care contributions from all state employers. And allowed employers to request tax credits if they were fully subsidizing employees' health benefits.	Died in Labor.
	HB 6606	Made relative caregivers who were subsidized guardians eligible for subsidized HUSKY B benefits.	Died in Human Services.
2000	HB 5858/PA 218 (codified at CGS § 38a-568)	Made self-employed people eligible for small employer coverage, thus eliminating HMOs' ability to refuse to insure employer groups of fewer than three eligible members.
	HB 5778/PA 213	Greatly expanded the ability of working people with severe disabilities to buy into the state Medicaid program.
	HB 5737/PA 187 (codified at CGS § 5-259(i))	Allowed employees of the Children's Center to participate in the state employee health plan.
	HB 5165	Gave large employers that were closing or relocating plants the opportunity to pay affected employees the value of 120 days of health benefits, instead of the actual benefit.	Died in Insurance.
	SB 532	Made people (1) with incomes up to 300% of the poverty level, (2) who lost health insurance for reasons other than quitting, and (3) who exhausted COBRA eligible for HUSKY B.	Died on foot of Senate calendar.
2001	HB 6712 /PA 30 (codified at CGS § 5-259(i))	Added employees of certain nonprofit organizations to the list of employees for whom the comptroller is authorized to procure health benefits. Also authorized her to arrange and procure alternative health benefits plan for municipal and nonprofit employees.
	HB 7503/PA 2, June SS (special act language, not codified)	Required DSS, in collaboration with the offices of health care access and policy and management, to prepare a plan for purchasing employer-sponsored health coverage.

Table 1: (Continued)

*Year*	*Bill/PA #*	*Summary*	*Status*
	HB 6608	Allowed tax-exempt, nonprofit corporations to participate in comptroller-procured health plans.	Recommitted to Planning and Development.
	HB 5607	Established a comprehensive affordable prescription drug program.	Died in Appropriations.
	HB 5632	Authorized the comptroller to negotiate health coverage for employees of nonprofit organizations and regional emergency medical service councils.	Died on House calendar.
	SB1007	Explicitly required public sector and a few private sector employers to continue health insurance coverage for employees as long as they were eligible for or receiving such benefits under workers' compensation.	Died in Appropriations.

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