Insurance and Real Estate Committee

JOINT FAVORABLE REPORT

Bill No.:

HB-6582

Title:

AN ACT ESTABLISHING THE CONNECTICUT HEALTHCARE PARTNERSHIP.

Vote Date:

3/10/2009

Vote Action:

Joint Favorable Substitute

PH Date:

3/2/2009

File No.:

4045

SPONSORS OF BILL:

Insurance and Real Estate Committee

REASONS FOR BILL:

To provide health insurance for the uninsured residents of Connecticut.

RESPONSE FROM ADMINISTRATION/AGENCY:

Nancy Wyman, Comptroller I am in agreement with the concept of the Healthcare Partnership, however, I have been working with the Speaker of the House to craft substitute language that could make this a viable workable program for the State and for our cities and towns. I am in favor of a self-funded pool that brings together the state employee plan and municipal employees. I will note that the state employee plan is currently a fully insured plan as a result of a collective bargaining agreement with SECAB (State Employee Bargaining Coalition) and that aspect needs to be addressed in order for this program to move forward.

In discussions with the Speaker, the substitute language will no longer include small business and not for profit organizations, but pools together employers and employees with a similar risk profile in terms of employee populations and work environment. It makes the partnership a permissive subject of bargaining for the municipality and portion of a town's employees as bargaining units merge into the plan and permits the Comptroller to deny participation if such a group results in a shift of disproportionate risk to the plan. Lastly, the language would permit us to adequately provide for a reserve fund that will protect cities and town from claims fluctuations that could result in mid-year assessment of additional premiums.

Susan Bysiewicz, Secretary of the State Small business are responsible for creating more than 90% of all new jobs in Connecticut, yet with skyrocketing health costs more than half of the state's uninsured population – about 180,000 people – are employees of small businesses.

Many organizations, reports and surveys indicate that the lack of affordable health insurance for small business owners is a priority that needs to be addressed. It is no secret that, in this time of economic crisis and uncertainty, small businesses are struggling with higher energy and other costs and a constrained credit market. Because of this and high health care costs, many small business employer have been forced to cut back on coverage, eliminate coverage all together or simply go out of business.

State employee health pool expansion is not a new concept. As many as 24 other states allow local government employees to participate in their State, employee plan, including Massachusetts, which opened it State employee plan last year. This bill would create a large pool of more than 200,000 people that would put Connecticut in a strong bargaining position when negotiating rates with the major health insurance providers.

Some have express concerns about the potential for the insurance providers to increase costs. That is why establishing a Non-state Public Health Care Advisory Committee is so essential. Members of that Committee would be able to advise the Costs Containment Committee on changes in benefit coverage and other bargaining issues.

Making quality health care affordable and accessible is good for Connecticut's economy and is good for taxpayers.

Richard Blumenthal, Attorney General This legislation allows municipalities, small business and nonprofit organizations to join the state employees' health insurance pool – enabling them to lower their health insurance costs. These employers can then join the pool if they feel it is a fiscally prudent alternative to their current health insurance plan for their employees.

Municipal governments, small businesses and non- profit organizations are faced with lower revenues and increasing health care costs for their employees. Many are abandoning health insurance coverage or imposing large co-payments on their employees.

A recent report found that 1 out of every 4 people postponed necessary health care procedures because they could not afford to pay for it. The costs of delay can be tragic. The state, through Medicaid and programs such as HUSKY, often ultimately pay for the larger costs once the medical condition worsens.

Opening the state employee health plan will allow these smaller employers the benefits of the state's bulk purchasing power. In turn, additional employees give the state plan even greater purchasing power than it currently has.

Teresa C. Younger, Executive Director, The Permanent Commission On The Status Of Women We support the intent of this bill because the increasing numbers of uninsured persons affect all genders, races and ages.

In 2006, 11% of Connecticut's population aged 25 to 64, and one-third of young adults, ages 19 to 29 were uninsured. As of December 2007, the Kaiser Family Foundation estimated that there means that medical interpreters must be provided and paid for a covered service in order to ensure that those with limited English proficiency are able to communicate effectively with their providers.

In addition, we urge you to include the following elements in any plan for health care.

1. Protect the confidentiality of women and girls.

2. Health care and insurance must be affordable

Elizabeth C. Brown, Legislative Director, Commission on Children The timing is perfect for this innovative, comprehensive solution to true systemic reform.

This bill seeks to maximize the current state employee health plan system to assist municipalities, small businesses and non-profit organization.

Opening up the State Employee Health Plan to these groups on a voluntary basis is a bold step in addressing the current health care crisis. It establishes an Oversight Committee to insure that adequate number of employers will join and work with these constituencies to maintain quality and affordability.

Doing nothing is not a solution. The bill will afford viable health care options that are just not available today in the market place. By opening the State plan, we will be able to provide many Connecticut businesses and their workers with access to a comprehensive benefit package, and provide the economy of scale necessary to keep the private insurance industry competitive and profitable.

NATURE AND SOURCES OF SUPPORT:

American Association of Retired People (AARP) AARP has long advocated that life-saving health care is right, not a privilege. We believe that the quality of the state employee health insurance plans coupled with the increased bargaining power and reduced administrative costs associated with a larger state plan pool should allow employees of municipalities, small businesses and non profit organization greater access to quality affordable health care.

Thomas H. Morrow, Executive Director, Bristol Community Organization, Inc. (BCO)

With a staff of 25 full time and 52 part time employees and a budget of $4 million, BCO is like any small business. We must negotiate with agencies or insurance companies to secure our health benefits.

The cost, quality and coverage for all Connecticut residents would be improved by the formation of one – and only one consumer purchasing pool.

John DeStefano, Jr., Mayor, City of New Haven This bill would the State employee pool and allow municipalities, small business and non profit organizations the option of joining the state pool.

Although this option would not benefit large municipalities such as New Haven who already have a large pool of insured, the option of joining the state pool would be a significant tool for smaller municipalities, small businesses and nonprofit organizations who are struggling to provide healthcare to their employees. Healthcare costs continue to rise at an alarming rate, forcing employers to make untenable choices.

Since we all share the mutual goal of helping small businesses grow their business and create more jobs for Connecticut, this comprehensive and thoughtful approach to making health insurance more affordable would drastically reduce the number of uninsured residents in the State of Connecticut while supporting economic growth.

Barry M. Simon, Executive Director, Gilead Community Services, Inc. This legislation recognizes community providers as an integral part of the public/private partnership in the Purchase of Service community healthcare system. The state pays us to take care of our clients in their community. At the same time the state asks us to deliver these services, it often fails to give us the funding we need to do so.

After more than 25 years of chronic under funding, any proposal that proves a measure of relief is welcomed. This bill presents an opportunity to address part of the critical issue for the community providers: the rising cost of doing business, in particular Health Care costs.

Community Providers are part of the solution for the future of the service delivery system and preserving the investment made in quality, cost effective, community care.

Lori Pelletier, Secretary-Treasurer, Connecticut AFL-CIO This bill would provide necessary relief to our municipalities by providing them with an opportunity to save money without jeopardizing quality. Until we can fix the current way health care is delivered, pooling is the best option. Municipal workers are being used as scapegoats by groups looking to balance municipal budget on the backs of municipal workers, and that the idea of municipal pooling is a solution that's long overdue.

In the last six years, the cost of health insurance has gone up almost 90%, and this is not sustainable for workers and it's not sustainable for employers by putting municipal employees in the state employee insurance pool potentially we could save taxpayers “hundred of millions of dollars”

Ron Cretaro, Executive Director, Connecticut Association of Nonprofits (CT Nonprofits) Nonprofit employers, like many other employers, have been facing years of skyrocketing healthcare prices. Annual percentage rate increases in the double digit leave nonprofit directors struggling to keep costs down for their employees.

The lower premiums and co-pays associated with this healthcare plan are a welcome option for our state's nonprofit providers. The cost of joining the state employee health insurance plan will not be affordable for all nonprofits, but it will certainly be a viable option for some.

Gian-Carl, Connecticut Conference of Municipalities (CCM) This bill would, among other things, provide municipalities with the option of enrolling their employees in the state's health insurance program.

The high cost of providing health care to municipal employees is hurting towns and cities across Connecticut. Two years ago CCM form an Ad Hoc Committee on Municipal Health Care Cost to discuss the present cost- related problems, and to generate ideas for assisting municipalities in coping with them. The committee's report discusses the problems municipalities face in finding affordable health insurance, steps they have taken to address those costs, and make recommendation for State action that can help local governments.

One important aspect of those recommendations is to provide local government with options of which they can voluntarily avail themselves, including through state programs. This bill provides such an option.

Municipalities will best be able to control rising health care costs if they have before them a menu of options so they can chose what works for their specific situation – including inter-municipal pooling, the Comptroller's plan for an “Enhanced MEHIP” program and the option of joining the state employee pool.

Bart Russell, Connecticut Council of Small Towns (COST) COST fully appreciates the opportunity to participate on the work group to review and discuss this bill to meeting the needs of towns and other stakeholders. The issues that COST, as advocates for the state's small towns, must focus on relative to this bill are as follows:

■ Voluntary Approach

■ Part-time and Seasonal Employees

■ Collective Bargaining

■ Non-Municipal Employees

Earl and Velma Estes, Meriden, CT We support this bill because healthcare is on o f the most important issues before every person. The problem is that everyone cannot afford the plans that are available now. Not only is affordability an issue, mediocre healthcare not good enough! Everyone should receive the very best health care available!

Marissa Cardona, Community Organizer, Universal Healthcare Foundation, Meriden, CT Having worked closely with people who are underinsured and uninsured, I have witnessed firsthand how challenging it is for families to receive quality care.

While other countries has declared health care to be a basic right, the US treats health care as a privilege, only available to those that can afford it, and like an economic good – not as a social or public good.

We need to prioritized health care because the price of not having health care would far exceed the price of having it. We all deserve quality health care.

Natalie Gill, Meriden, CT I work with the underinsured and uninsured through the WIC program and see the many challenges that families and children face when in this situation. Many of my clients express their frustration with our health care system and have to wait months for their babies, toddlers and or children to be seen by a Doctor due to the overwhelming waiting lists. Because of the waiting lists, some families have to go to the Emergency Rooms and it is very expensive to pay their bills when put in that situation. Most of these children are not receiving timely preventative care and cannot receive quality dental care because there are only a few dentists that will accept HUSKY.

Stan Soby, Vice President, Community Programs at Oak Hill Oak Hill is a community-based nonprofit provider located in Hartford, with over 100 programs in 58 towns in Connecticut, providing services and supports to over 500 individuals every day. Oak Hill provides Birth to Three program, educational, residential and vocational services to individuals with visual impairments, individualized support to people with Autism and Asperger's Syndrome, Assistive Technology services, including to service member injured in combat, and low-cost, restored durable medical equipment to anyone with a disability who will benefit from it.

We offer health insurance to over 750 staff whose positions with us are twenty or more hours per week, with individual coverage from some 350 staff and coverage for spouses, children or families for the other 400. Our health insurance cost this current year is over $7.9 million. This cost is just under 10% higher than last year. That is a $900,000 increase in a year in which we have received no increase in our rates. The increase from last year to this would have been higher had we not chosen last year to offer a high Deductible Health Plan with a Health Savings Account to eligible staff and to insure the $1,500 ambulatory services and inpatient services deductible for the other plan.

Over the years, our employees have shared the cost of increase through higher deductibles and increases in their monthly contributions. Later this month, we will begin negotiating a wage and health benefit reopener to our collective bargaining agreement with District 1199. We know that maintaining affordable, comprehensive medical care will be a critical part of these negotiations. We do not want to be in the position of balancing cost and coverage on the backs of our employees as we face two more years of zero percent rate increases.

We are encouraged that the Healthcare Partnership could provide plans which are priced less than what we are currently paying with comparable, if not better, coverage. Based on our experience, we find the 8% cap that is built into the current contracts is a key element. Knowing that participation would be voluntary is an important feature of the Healthcare partnership, as many of our colleague agencies may not find the plan affordable to them.

Kevin Lembo, State Healthcare Advocate, Office of the Healthcare Advocate (OHA) This bill is one of several promising proposals circulating through the Capitol for committee action. The goals of this bill are good and the bill needs to be examined in tandem with similar and already enacted laws involving public employees such as MEHIP. This bill would also convert the plans under section 5-259(a) of the general statues from fully-insured to self-insured plans. If the plans are converted, we must maintain compliance with the consumer protections contained in the insurance statutes. Conversion to a self-insured product would allow the state more control over the healthcare partnership and state employee plans, and will provide the state with additional tools to drive down costs. In today's rough economy, we have to be careful not to jeopardize the predictable costs we now pay in the full-insured plan. Recently, Comptroller Wyman and her staff negotiated very attractive contracts for the state. A thorough analysis of the projected versus actual utilization of services must be undertaken before we commit to the conversion to self-insured.

I am please to see the idea of pooling of risk on a large scale as a strategy to bring down health costs and to use the savings to expand healthcare coverage. As far back as 2006, I warned against the risk of segmenting the market and the need for pooling risk and developing strategies with all stakeholders to address access to healthcare, so I am delighted to see the idea of pooling large groups becoming more in the mainstream of our healthcare reform thinking and continue to support this concept.

Lynn Warner, Executive Director, The Arc of Connecticut For years the private providers serving individuals with intellectual disabilities have served these individuals with dignity while providing a high quality of care. However, for years private providers have been consistently under funded, subjected to unfunded mandates, consistent lack of cost of living increases and extensive rate changes. In addition to these funding hurdles – Private Providers are often forced to charge their employees healthcare contribution rates that many of their employees simply cannot afford. This system often results in workers and at times their children and families, who are often uninsured or underinsured – some are even on the HUSKY program.

Private non-profit providers want to be able to offer the best possible benefits to their employees – benefits these individuals truly deserve.

Employees who are paid a competitive wage and/or receive quality benefits are more likely to give more of themselves to the people they are responsible for caring for if they are not as worried about what will happen if they or their child gets sick or if they have to choose between food or medication.

If staffing turnover rates decline and long-term consistent relationships between the staff members and the individuals in trusted in their care are formed then everybody wins. No one gains anything when employees cannot afford to work at an agency or worse yet, forced to work two or three jobs at a time.

On behalf of the 23 non-profit Local Chapters of The Arc of Connecticut, I urge you to support passage of this bill.

Paul J. Rapanault, Director of Legislative/Political Affairs, Uniformed Professional Fire Fighters Association of Connecticut Our 4,000 members serve in 50 fire departments throughout the state.

As employees of Connecticut's municipalities, fire fighters are concerned with the economic health of our communities. This bill offers towns and cities the opportunity to provide their employees top quality health care while saving residents thousand of dollars in premiums. This is an opportunity that should not be missed.

Chaucey Perreault, Meriden Children First This bill would allow non-state public employers, municipal-related employers, small employers and nonprofit employers to join self-insured plans. This would result in important savings for these groups and increase overall transparency.

Your support would put Connecticut at the top of the heap as a national leader in quality and affordable health care coverage.

Michael Friemuth, Director of the Office of Intergovernmental Relations, City of Stamford Insurance makes up nearly $35 million of the city's overall $445 million budget. We have seen annual increases in health care costs form 8 to 10 percent over the last few years and are constantly searching for ways to control these costs.

Should the saving be truly possible and justified and with municipal choice to enter the program, the city is supportive of this bill. As a self-insured entity today, we are able to manage our risk and to control some of our exposures. We participate in a larger pool today for our prescription program and we are doing better. It therefore stands to reason that participation in a larger state pool will also offer us some options and competition to mitigate these ever growing municipal expenses.

We offer the help our employee benefit team to the committees to further pursue this opportunity and to evaluate the options and program designs before you today.

Mark Masselli, President/Ceo, Community Health Center Right now our nearly 400 employees are seeing the worst effect of this economic crisis that our nation is facing. More patients are coming through our doors. We care for people from all walks of life, including many people who work for small businesses, small non-profits and community groups who also face the same crisis and need a helping hand to pay for health insurance.

This bill also makes an important statement in diversifying fair access to healthcare throughout the state. Approximately 70 percent of our employees are women – some of them single parents. They should have the best coverage too. Some of the other community groups who would benefit from this legislation reflect the growing diversity of our state.

This legislation makes an important statement about our state's future – because it invests in the families and children of our public servants, small business and employee of nonprofits.

AFSCME Council 15, Connecticut Council of Police Unions Council 15, representing sworn police officers in 62 municipalities in Connecticut, supports health care reform. Health care reform would apply savings from administration and profits to expanded and improved coverage for all. Economic necessity and moral conscience compel us to seek a better way.

Joan F. Goodman, Meriden, CT Health care and the economy are intricately intertwined with each other. Over the past year the small company my husband works for has been cutting back. After enduring, pay and insurance benefit cuts and increased in premiums, my husband was laid off.

I am now working three part time jobs with no benefits. We have worked hard, and saved money. He had a good job and good health insurance. Everything can change so fast.

These times are nothing like we have ever seen. We need courageous leaders who are willing to take bold steps to boost the economy, provide more affordable, quality health care that saves money in the end for everyone and helps the residents of Connecticut build themselves up again.

David Radcliffe, Director, Taxpayer, Husband and Father of Three Young Boys, Meriden Children First Health insurance costs are skyrocketing. With each passing day, more and more people in Connecticut are losing health insurance coverage for themselves and their families. Our current system of health care is broken. We urge you to act now and to act boldly.

Your support would put Connecticut as a national leader in health care coverage that is quality, affordable and accessible.

Miguel A. Cardona, Principal, Hanover Elementary School, Meriden, CT Connecticut's health care system is in crisis;. We truly need quality, affordable health care in Connecticut. The people most affect by our broken health care system are the middle class citizens, hard working people and families like yours and mine.

Working in the field with children, I see first hand how poor quality health care service or no health care service affects children's ability to learn.

Implementing universal health care can help less the gaps in achievement between those that can afford it and those that cannot. Please work to provide this fundamental right for all Connecticut residents.

Natalia Perez, Meriden, CT I had a great job with good a health care plan for over 30 years. Three years ago I was diagnosed with spinal stenosis, thyroid disease and sever arthritis. My doctor was shocked to know that I was working under these conditions and immediately told me that I could not go back to work because my condition will continue to worsen.

My doctor was right. I am feeling worse and most of the time struggle getting out of bed due to the severe pain. I have applied for social security four times and have been denied and at times regret having seen my doctor because now I am uninsured for the first time in my life and cannot afford the necessary prescriptions to take away the constant pain.

It's very challenging for me to see that I worked hard to provide for my family and to give my children a college education. I worked hard to live the American Dream and now I have to make decisions on whether to pay my bills or buy my needed prescriptions.

I urge you to think of the hard working families who are most affect in our state. We need to implement a plan in Connecticut to cover everyone.

Andy Markowski, Connecticut State Director, National Federation of Independent Business (NFIB) NFIB supports the intent of this bill. No one solution will help cover rising healthcare costs, but a multi-faceted approach, led by reforms at the federal level, will allow small-business owners and their workers to find affordable health insurance. This approach should include health-insurance pools (particularly private) for small businesses, tax-based incentives to assist with the purchase of health insurance and implementing cost-containment measures.

Christopher G. Donovan, Speaker of the House The major change to the current proposal is that the state employee health plan will switch from fully insured to self-insured under an agreement between the state employees and the State. This will result in an immediate savings to the State equal to approximately two months of premiums.

The State will pay actual medical claims directly to medical providers through an administrative services only (ASO) arrangement with a third party administrator. The savings are a result of the transition from paying monthly premiums (which include risk service charges) up front to pay the actual claims after they have been incurred.

A self-insured plan will allow the state to realize long-term savings by directly managing the medical claims and health service utilization. The State will be able to create real incentives for wellness and prevention and use scientific data for case management services to keep healthcare costs down.

I hope you will agree that this is an important step toward our goals of saving state dollars, providing relief to municipalities, and the small businesses and non-profits we rely on, and expanding access to high quality affordable healthcare options.

Tom Sullivan, Executive Director, The Arc of New London County As you know, the non-profit workforce is low paid. Many employees work for our agency so that they have the opportunity to obtain health insurance. We want to ensure that we offer the best plan possible. A happy, healthy and motivated workforce translates into better quality in our services. Being able to offer State Insurance plans would help us retain existing employees and recruit new talented people to come into our field, since employee assign such a high value to good and affordable health care.

Andrew P. Reynolds, Taxpayer, Husband and Father of Three Young Children, Owner/Publisher, The People's Press Healthcare insurance costs are skyrocketing. These are difficult times. We look to you for strong leadership on fixing our health care system once and for all. Your support will provide the quality, affordable health care system that we all deserve.

NATURE AND SOURCES OF OPPOSITION:

Christine A. Cappiello, Director, Government Relations, Anthem Blue Cross and Blue Shield We have some concerns about this bill. We think it is important to remind members of the committee some basic insurance principles. One of those is around healthcare premiums, which are the combination of retention expense and projected claim expense.

Medical claim expenses account for 80-90% of total healthcare premiums. In order for this bill be successful and address the underlying needs of affordability in health insurance, there needs to be an understanding of how important it is to develop an actuarial model that addresses projected claims costs with the constructs of this proposal.

Voluntary participation creates a unique set of actuarial challenges. We believe initially you will attract those groups that carry higher monthly claims expense. These new entries threatens rate adequacy in the initial years and could threaten the viability of the pool in later years.

Without the option to align risk, two things can occur:

1. Rates for the entire pool could possibly be inadequate and groups with better risk could potentially seek insurance outside of the pool.

2. Unanticipated change in enrollment among the plans within the program could create inappropriate funding in one of more of the plan. This could set up inadequate funding in the first year followed by significant rate increases for the pool upon renewal.

A program that is structured on strong actuarial principles provides a plan that can last into the foreseeable future.

Robert L. Genuario, Secretary, Office of Policy and Management This bill will not lead to reducing the number of the uninsured nor will it reduce costs. In fact, the evidence indicates that this bill will increase our costs for public employee health benefits at a time when we are struggling to make resources available to meet the needs of our most vulnerable populations.

As we discussed last year, the pooling proposal gain contained in this bill us fundamentally unworkable.

As it happens, the US Congressional Budget Office, in its December 2008 report, looked at the issues associated with opening up the Federal Employee Health Benefit plan in the same fashion as the bill proposes to do with the State employee plan. According to CBO, if those joining the federal plan were to pay the same premium as federal employees, as is being proposed in this bill, the FEHB plan would most likely attract those with above-average costs for health care. As a result, the uniform premium would rise causing the cost to increase for federal employees, the federal government and those joining the plan. This is exactly the reaction we saw from the market when this proposal was raised here in Connecticut last session.

We note that the bill does provide for a community-based rating under existing State law for small business seeking to join the State plan. Under these provisions, factors such as age and geographic location can be utilized in setting rates, but not health history. Using the federal example once again, however, CBO predicts that the total premiums charged to non-federal employees would likely still be substantially higher than those observed in the individual market based on adverse selection issues.

This bill contains a provision for the Comptroller to covert the existing state employee health plan to a self insured plan for the benefit period beginning on or after July 1, 2009. The State is currently in the first year of three year contracts with each of the health care insurers. The State has procured caps for the premium increases in the next two years. The caps guarantee that the premiums cannot increase by more than negotiated cap percentage amount. This effective cost containment tool will be eliminated if switched to a self insured plan.

Currently, the state employee plan is experiencing high claims activity and switching to a self-insured plan at this time will not only shift the risk from the insurers to the State but will also cost the State more money, thereby increasing the anticipated deficits projected during the biennium. To not establish a reserve for the medical claims would be extremely reckless.

Adding a large, unknown group of employees and retirees to the current pool would drive changes in utilization rates and claims costs. Material changes such as these require renegotiation of the agreements.

We continue to have serious reservations regarding the adverse consequences on the State budget that would result from passage of this bill. Also, this bill does not decrease the number of those who are uninsured. Rather it merely provides a more generous benefit package to those who choose to sign up for it and passes that cost along to state taxpayers.

Metro Hartford Alliance, Hartford's Chamber of Commerce and the Region's Economic Development Leader We write today in strong opposition to this bill. Our investors believe it is important to focus on market-based solution and engage in public-private partnerships to reach our goal of improving the current health care system, which covers over 90% of Connecticut's residents, among the highest percentages in the country. To this point, we supported and participated in the Connecticut Health Insurance Policy Council (CHIP) in 2007, a non-profit entity which focused on controlling health care costs and expanding access to quality health care – recommendations that the Alliance endorses.

The CHIP recommendation focused on encouraging individuals to take personal responsibility for their wellness, make appropriate use of the state's robust health care system and participate in one of Connecticut's existing health insurance plans. The CHIP report specifically emphasized the need to:

● reduce the number of existing mandates and allow greater efficiencies in product development and approvals at the department level to create flexible options, and improve access to affordable care;

● promote healthy lifestyles with employer-sponsored wellness programs and greater emphasis on prevention overall.

● increase Medicaid reimbursement rates to hospitals, which are receiving only 73 cents on every dollar of care to Medicaid patients, forcing over all health care costs to rise;

● use e-medical records, electronic information exchanges and telemedicine more efficiently to improve patient safety, expedite treatments and reduce redundant care, ultimately reducing costs; and

● provide more quality data to consumers to help them make more informed health care choices.

Tanya Court, Director, Public Policy & Programs, The Business Council of Fairfield County Health care reform should be a central part of our state government's effort to protect its most vulnerable citizen, stimulates its economy, increase workforce productivity and control spending. This reform should be comprehensive in scope, phased in implementation, build on the strengths of the current system which remedying its deficiencies, and be undertaken in coordination with new directions in federal health care policy.

In this bill the approach only expands a state employee health insurance plan that is costly and falls short in the vital areas of wellness, condition management and preventive care. We are concerned that the State Employee Health benefit plan design is not sustainable in the long term with regard to costs to society. We also have concerns regarding costs, wellness programs, accountability with treatment protocols, cost control by health care providers, excessive premiums for self employed individuals with pre-existing conditions, and does the plan reimburse providers regardless of the quality of care provided?

Based on the best information and assumptions we have been able to gather, we believe the bill to be counterproductive and strongly oppose its passage.

Susan Haplin, Keith Stover, Connecticut Association of Health Plans We find that this bill falls short in the following areas:

1. No new individuals are covered by this bill.

2. The bill does not provide any roadmap to sustainable reform.

3. The bill does nothing to bring about systemic cost savings.

4. The bill makes no attempt to bring value-based or wellness-based benefits to the state employee pool.

5. This bill does nothing to enhance the position of Connecticut's insurance industry.

Susan C. Winkler, Executive Director, Connecticut's Insurance and Financial Services Cluster The state's plan is already too rich and expensive. If we really want to increase access to affordable healthcare, then this is the wrong strategy.

Robin Wilson, President & CEO, Quinnipiac Chamber of Commerce Offering small businesses the opportunity to join the state health insurance plan will do very little to provide small business with affordable health care options for themselves and their employees.

You should allow small employers to purchase health insurance with fewer mandated benefits.

We support efforts to improve overall health through wellness and chronic disease management programs and incentives for employee to take advantage of such incentives. Wellness programs are a proactive solution to help employers hold down health care costs by encouraging positive, healthy behaviors.

Eric George, Associate Counsel, Connecticut Business & Industry (CBIA)

1. Improving health care in Connecticut must be achieved in a way that will meet people's needs, helping the state's economy recover and grow and be the model for the nation.

2. Better health care means making private health insurance more affordable and accessible.

3. Without a healthy economy and the good jobs and benefits it brings, meeting Connecticut's health care needs will be impossible.

Truly comprehensive health care reform must encompass the following:

1. It must promote quality

2. It must reduce costs

3. It must increase access

The general concept of this bill is to have municipal employees, small employers and nonprofit organizations join the expensive state employee health insurance plan. This is troubling for the following reasons:

1. The state has not done a good job in containing it own health care costs.

2. This pooling system would operate outside Connecticut's insurance laws.

3. Any employer group participating in the program would have to make a very lengthy two-year commitment.

4. Large-scale purchasing pools have actually not addressed the high costs of health care – for example: America's automobile industry.

This bill would move Connecticut closer to a government-run care system. According to a CBIA/Zogby International survey, nearly three-quarters of state residents said that the best health care reform would be to control health care reform would be to control health care costs to make private insurance more affordable rather than moving towards a government-run health care system.

Reported by: Anne Ramsey

Date: 03/17/2009