Decision Time Approaching on Ways to Reform Health Care

With less than two months to go in the 2009 legislative session, lawmakers are considering proposals that have the potential to achieve real health care reform—or make the situation worse.

Everyone agrees on the need for health care reform and that the challenges consumers face are daunting – including skyrocketing costs and sometimes less-than-ideal quality.

Out of the hundreds of health care measures proposed this year, lawmakers are approaching a clear divide in the road to reform. Some proposals would improve our health care system, and others would make our system more costly and even less accessible.

Positive
Among the proposals that could help bring health care reform are those that would:

• Direct the use of federal stimulus dollars to increase health care access by raising Medicaid reimbursement rates (HB-6675)
• Reduce health care costs and improve quality by developing Connecticut’s electronic medical records system (SB-782)
• Establish a health care cost-containment authority to analyze ways to reduce costs (SB-678)
• Create a way to review all existing and proposed health benefit mandates to determine their costs and benefits (HB-5018)
• Promote quality-improving and cost-reducing reforms—such as care coordination, improved health status efforts, preventive care, and data compilation and transparency (parts of HB-6600)

Expensive
On the other hand, proposals that would make the health care situation worse by increasing costs include those to:

• Open the expensive state employee health plan to small companies and other groups, enable the plan to operate outside Connecticut’s protective health insurance laws, and force taxpayers to shoulder the cost burden under a self-insured system (HB-6582)
• Create a massive, government-run health care conglomerate, charge many employers to pay for the new system and force taxpayers to shoulder the cost burden under a self-insured system (parts of HB-6600)
• Increase health care costs and reduce flexibility for small businesses by requiring that health insurance policies cover certain things (SB-290, SB-299, SB-301, SB-638, HB-5021, HB-5023, HB-5093, HB-5433, HB-5672, HB-5673, HB-6240 and HB-6540)

Very expensive
Even the legislature’s Office of Fiscal Analysis (OFA) agrees that the massive state-run health care conglomerate envisioned by HB-6600 would be very expensive. OFA compared the administrative bureaucracy proposed under HB-6600 to the Massachusetts Connector established under the commonwealth’s recent health care reform law (because there is no equivalent state agency in Connecticut).

According to OFA, the “Connector has an estimated administrative operating budget for FY 09 of $35. 1 million with total health premium coverage of $782 million. Direct staff salaries and benefits are estimated to be $6.2 million for FY 09, and other administrative costs of $28. 9 million.”
Most of the remaining provisions in HB-6600 could significantly improve Connecticut’s health care system. But its proposal to create a state bureaucracy is an ill-conceived idea that comes at the wrong time, just when Connecticut is experiencing a serious fiscal crisis.

CBIA strongly encourages state lawmakers to take the right road—reject any controversial, costly and government-expanding provisions and proposals and instead adopt the positive reforms that will lower costs, bolster quality, and increase access.