Thousands of people in Connecticut will be added to Obamacare coverage. Democrats broaden health care access as expanded state role again falls short.

Hartford Courant (CT)

Democrats who control the General Assembly have advanced a top priority of broadening access to health care even as their plan for a greater state role in providing insurance ran aground in the face of stiff business opposition.

Legislation enacting Connecticut’s two-year budget includes a “Covered Connecticut” program that expands access to subsidized health care for those with household income of up to 175% of the federal poverty level, or $45,850 for a family of four and $22,330 for an individual, according to the U.S. Department of Health and Human Services.

The state Office of Health Strategy will be required to expand coverage to dental benefits and nonemergency transportation by July 1, 2022.

The cost is expected to be $8 million in the state’s 2022 budget year beginning July 1 and $17.3 million 2023 for the expansion that assumes about 31,000 people enroll by the end of the 2023 budget year.

The state assumes a 50% federal reimbursement and continuation of the American Rescue Plan Act subsidies approved by Congress and President Joe Biden in March. Costs would be about 10% more if Congress does not extend the increased health insurance subsidies.

The budget provision will make health insurance free for individuals below that threshold by combining Medicaid with expanded subsidies, said Sen. Matt Lesser, co-chairman of the legislature’s insurance committee. Expanding access to Connecticut’s health insurance exchange was a priority of the Democratic majority who said many residents are making too much for Medicaid but too little for subsidized health insurance, leaving them exposed to crippling medical costs.

Legislation also will provide universal access to health care for children up to age 8, regardless of their immigration status.

The result of is that “tens of thousands of people are going to have coverage who wouldn’t,” said Lesser, a Middletown Democrat.

“I wish we had gone bigger but this is an innovative step,” he said. “It’s making the Affordable Care Act truly affordable.”

Senate Republican leader Kevin Kelly said the legislature missed an opportunity to cut health care costs rather than rely on Medicaid.

“Medicaid is by no measure a gold standard in health care,” the Stratford lawmaker said.

With more people on Medicaid, physicians will compensate for the discounted medical care by charging more for patients in their private practice, driving up costs, Kelly said.

Republicans have instead called for benchmarking, a practice they say would reduce health care costs by setting prices on procedures and using data to identify savings.

Comptroller Kevin Lembo and legislative Democrats were again turned back as they tried to advance a so-called public option that would have extended to individuals and small businesses access to an insurance pool now tapped by municipalities. Legislation collapsed under strong opposition from the insurance industry, a big player in Connecticut, other businesses and Gov. Ned Lamont.

“We’re home to a big chunk of the industry and I get it,” said Lesser, D-Middletown. “It’s not a surprise to me there are a lot of people making an awful lot of money denying health care to people.”

Susan Halpin, executive director of the Connecticut Association of Health Plans, said the decision “to partner with the private sector to expand health care coverage on the exchange was the right move for Connecticut.”

“We commend the governor and Democrats and Republicans who saw through the false promise of public option and supported Connecticut’s economy instead,” she said.

Lesser said small business owners have been left behind by a marketplace that’s in a “state of failure.”

Andy Markowski, a spokesman for the National Federation of Independent Business, an advocacy group, said small-business owners would like more options in a market with a limited number of carriers.

The most recent entry is Cigna Corp., which announced in April it will launch a health insurance policy July 1 for businesses with up to 50 employees.

Markowski said health insurance costs are the “No. 1 concern” for owners and employees. The focus should be “on plans that are affordable, flexible and predictable,” he said.

“Unfortunately, what we’ve seen in predictability are premium increases approved,” Markowski said. “Some are nominal. Some are significant, with 10% or more.”

Stephen Singer can be reached at [email protected].