For decades, Connecticut and other states have used a fee-for-service model to pay for health care: the provider bills for each service, every consult, every procedure, every test, every pill. State Comptroller Kevin Lembo and many others have come to view that system as seriously flawed. It not only contributes to skyrocketing medical costs but also fails to deliver optimum care, Lembo said. “The incentives in that model are problematic,” Assistant Comptroller Josh Wojcik said. “It incentivizes volume.
The legislative session began with Democratic lawmakers, advocates and state Comptroller Kevin Lembo all confident that a series of long-sought big ticket health care reforms — including a public option for small businesses — were finally within reach. When the session ended at midnight Wednesday, however, virtually their entire agenda had failed to pass, with several major initiatives dying in the final hours. It was a bitter pill for health care proponents, particularly the death of the public option. In the end, the state’s powerful insurance and hospital interests proved too big an obstacle to overcome, advocates said. As of May 10, the most recent date for which records are available, the biggest and most powerful among them had spent nearly $3 million on lobbying during the session, including $480,079 by the Connecticut Hospital Association and $191,021 by Yale New Haven Hospital.
While tolls, bonding and the budget have dominated this legislative session, a battle has been quietly brewing over the creation of a state-administered health insurance public option for small businesses. That fight is about to burst into the open as the session heads into its final weeks. It pits GOP lawmakers and some of the state’s most powerful lobbies—big insurers based in and around Hartford and the Connecticut Business and Industry Association (CBIA)—against state Comptroller Kevin Lembo, Democrats who control the General Assembly, and patient advocates. Backers say their legislation would provide small businesses with a desperately needed alternative to increasingly unaffordable commercial plans, while injecting greater competition to force down prices. Opponents counter that a public option would harm the state’s insurance industry, potentially leading to job losses.
Although Gov. Ned Lamont said nothing about health care policy in his inaugural speech to the General Assembly, it’s likely to be a major theme of at least his early months in office. Why? Depending on how it’s calculated, health care makes up 25 to 30 percent of the state budget, according to the Office of the State Comptroller. Lamont will have to balance the need to save money with the desire of many inside and outside the General Assembly to expand and improve health care coverage and lower costs for consumers. “There’s almost two levels,” said Patricia Baker, president and CEO of the Connecticut Health Foundation, which focuses on assuring health equity and access to affordable care for all.