Gov. candidates differ on healthcare

Gov. Ned Lamont and Hamden state Rep. Josh Elliott are offering Democratic primary voters two vastly contrasting visions on healthcare for all.

To Elliott, the health insurance industry should not exist, and he is proposing what he calls "a real public option" that gradually moves Connecticut to a single-payer system by first slowly bringing more working people into the state employee health plan.

"All we have to look at is the rising costs of healthcare and the rising costs of health insurance to know that there is a problem that people can't afford to live here," Elliott said. "So, it is really a question of whether we work within the status quo in the system we have, or do we try to work toward a different model?"

In contrast, Lamont envisions a "Connecticut Option" health plan for small businesses, nonprofit organizations and individuals designed by the state government, but run by private insurance companies. It would be added to the offerings on the state health insurance exchange, Access Health CT.

"Let us walk before we run, but that's what we're going to get to," Lamont said.

The governor is also campaigning on establishing the Covered Connecticut program that offers no-cost health insurance through Access Health CT to qualifying low-income state residents ages 18 to 64 who are ineligible for Medicaid coverage. Elliott voted for the 2021 legislation that authorized the program.

Meanwhile, Greenwich state Sen. Ryan Fazio, the Republican nominee for governor, is proposing to allow so-called "association health plans" in Connecticut that allow trade groups, chambers of commerce and professional associations to join together to offer large group health plans to members.

"Connecticut families and patients are struggling after eight years of double-digit healthcare premium increases under Governor Lamont," Fazio said. "The last thing Connecticut families need is more tax increases to fund DMV-type healthcare. Unfortunately, that is what will happen if Governor Lamont or Representative Elliott pass their proposals."

Growing costs of healthcare

The one point of agreement between Elliott, Lamont and Fazio in the governor's race is healthcare in Connecticut is unaffordable and expected to increase unless something is done to lower rising healthcare costs.

In 2025, Connecticut ranked as the fifth most unaffordable state for healthcare costs, with the second highest insurance coverage costs and the fourth highest annual premiums for individual coverage nationwide, according to the governor's office.

The state Office of Health Strategy stated in its latest annual report on healthcare spending trends that healthcare expenses are growing faster than Connecticut residents' ability to afford services. The OHS report said small businesses continue to face challenges to provide adequate health insurance to their employees while continuing to invest in economic growth.

Total healthcare expenditures for Connecticut residents were $38 billion in 2024, according to the most recent annual state figures. This represented an 8% increase over 2023. Per capita health expenditures in 2024 averaged $12,332, according to the latest annual OHS healthcare benchmark report.

Connecticut insurers are proposing double-digit rate increases for 2027 for individual and small-group plans both on and off the state-sponsored exchange.

Four health insurance companies are asking the state Department of Insurance for an average 16.2% increase for individual plans and an average 17.8% increase for small-group plans for businesses with 50 or fewer employees, according to the proposed rate filings. The plans cover approximately 220,000 people, including 157,000 through individual plans and 63,000 through small-group plans, according to the Department of Insurance.

The state insurance commissioner will make a final decision on the rate filings in September, either approving, modifying, or denying the rate requests.

State insurance regulators last year approved 2026 rates that represented average increases of 16.8% for individual plans and 13.1% for small-group plans. Insurers requested a 28% increase for individual plans and 16% for small-group plans. Without the reductions, consumers would have paid $125 million more for health coverage, according to the Department of Insurance estimates.

The Lamont position

The debate between Lamont and Democrats in the legislature over a state-funded public option health insurance plan goes back seven years to his first days in office.

Lamont adamantly opposes the state government being the primary provider of health insurance for all through a single-payer system, or offering a voluntary health insurance plan on the marketplace to compete with private insurers because he said he believes each approach puts too much risk on taxpayers, while his proposal puts the risk on insurance companies.

With a single-payer system, Lamont said taxpayers would have to pay for cost overruns because the government acts as the sole funder and underwriter of the program.

"We put enough on the backs of taxpayers," he said.

Lamont said a state government-sponsored health plan is a dicey proposition, too, because changes in federal law and policy could pose significant risks to the plan.

"There is an awful lot of risks. If the feds do something, I don't want that to be on the backs of the taxpayers," he said.

In December, Lamont directed $115 million from a special contingency fund to partially offset the loss of Affordable Care Act subsidies that had helped tens of thousands of state residents pay for health coverage through the state-run health insurance marketplace. Nine out of 10 enrollees in Access Health CT had benefited from the enhanced COVID-era tax credits that expired Dec. 31 after Congress failed to extend those subsidies for a second time.

Lamont proposed to spend $1 million to have the state Office of Policy and Management assess the feasibility of developing a publicly designed, but privately run Connecticut Option plan and how it might be designed, including exploring opportunities to maximize federal funding to reduce premiums and overall healthcare costs for consumers.

The legislature authorized the OPM study.

The Elliott position

Elliott said the Connecticut Option proposal further underscores that Lamont is content with the status quo of profit-driven private insurance companies making money from collecting premiums and denying care.

"This idea that government could not do insurance is ludicrous to me," Elliott said. "We know these health insurance companies make massive profits. For us to say that we could not save people money by doing this better is just factually inaccurate."

Elliott proposed legislation in 2025 to allow the state to establish a single-payer healthcare program. The bill proposed allowing the state to negotiate health insurance coverage for employees of municipalities, nonprofit organizations and businesses with no more than 10 employees.

"I know that you either have to go towards a sort of public option or single-payer," he said.

As a candidate for governor, Elliott said he proposes gradually opening the state employee health plan to municipal employees first, then to nonprofit organizations, and finally to small businesses.

"So, the goal is to continue every year to be growing this plan out that we have because it is the best plan in the state, and we should be proud of it, and we should get everyone possible into it," he said.

Elliott said he would also increase the subsidies for individuals for purchasing coverage through the state health insurance exchange.

Elliott said association health plans would be the wrong way to go.

"I will do everything in my power to ensure that no associated health plan sees the light of day in Connecticut," he said. "All that does is distort our market. It is not the answer. It takes out potentially healthy players from the public market and makes that market harder and harder to survive, thereby killing what is already at risk."

The Fazio position

Fazio said association health plans would help lower soaring insurance costs and insure thousands of workers across Connecticut by permitting businesses, nonprofit organizations, and self-employed individuals to pool together to buy insurance as a large group.

The Republican nominee is also proposing to reform the certificate of need process that healthcare providers must go through to make major changes, such as acquisitions and mergers, substantial capital investments in new equipment or facilities, changing access to services or discontinuing a medical service.

Fazio said this will be more effective than what Lamont and Elliott are proposing.

"There is a better way," he said. "I'll pass the bipartisan association health plans that will give more choice and lower costs to families, and I'll pass certificate of need reform to eliminate the red tape that drives up the cost of healthcare. We can reduce healthcare costs in Connecticut with a real change in direction."