"Obama-Ready" Public Health Insurance Plans Approved by CT House

"Obama-Ready" Public Health Insurance Plans Approved by CT House

Thursday, May 28, 2009




"Obama-Ready" Public Health Insurance Plans Approved by CT House

Note: Key players in passage of these CT models for health reform, including Speaker Christopher Donovan, the Universal Health Care Foundation of Connecticut, the CT SEIU State Council and AFSCME Council 4, will be honored for this work at Progressive States Network's annual gala

Last week, the Connecticut House of Representatives passed two bills that proponents say will make Connecticut "Obama-ready" for national health care reform being debated in Congress.  Most notably, each CT bill would create the choice of a public health insurance plan in the state.

The Connecticut Healthcare Partnership (H.B. 6582), sponsored by Speaker Christopher Donovan, would self-insure the state employee health insurance pool and open it up to small businesses, non-profits and municipalities; and, SustiNet (H.B. 6600), authored by the Universal Health Care Foundation of Connecticut, would create the choice of a new public health insurance plan for residents and businesses as part of a broader comprehensive reform initiative.  Both initiatives are strongly supported by majority Democrats and are viable together or as stand-alone reforms.

Connecticut Plans Highlight Models for Public Insurance Plan Options:  The passage of these bills, after almost ten hours of floor debate, puts Connecticut at the heart of the national health care debate - whether to provide Americans with the choice of a public health insurance plan that competes side-by-side with private plans.  Connecticut lawmakers, as well as legislators across the country, are weighing in and asserting that public plan choice is an absolute necessity.

As CT Speaker Donovan said,

“We’ve got a chance to make sure Connecticut is Obama-ready. The time for healthcare reform in this country, and in Connecticut, is long overdue. With reform now a national priority, we can position Connecticut for a leadership role in giving our families healthcare they deserve. These bills will provide those families with real healthcare options, can provide economic relief to the state, our towns, small businesses and non-profits at a time of need, and will ready Connecticut for federal reforms when they are passed.”

The need for change in Connecticut is highlighted by a New America Foundation report on the "cost of doing nothing."  New America found that Connecticut lost $2 billion, or $6,126, per uninsured resident in 2007 in lost productivity due to the shorter lifespans and poor health of the uninsured, the third highest level in the country.  By 2016, the report finds that employer-sponsored health insurance costs for a family will jump from $14,300 to a staggering $25,000.

CT Healthcare Partnership:  The Partnership would allow small groups to pool with the state employee plan, which has more than 200,000 members. This would generate significant bargaining power and savings for plan members, enabling small employers and municipalities to achieve more favorable rates for comprehensive coverage. The bill's fiscal note, in fact, says that small towns and small businesses "will achieve savings from the state's large-group purchasing power, pooled risk and administrative economies of scale." 

While more than 20 states allow similar pooling of state and municipal workers, Connecticut would be the first to allow small businesses to join the plan at such a large scale.  The plan would infuse the state's health insurance market with competition and force private insurers to work harder for small group market share.  As Speaker Donovan said, "This will allow businesses to stretch their dollars further, attract talented people, and grow their organizations.”

By self-insuring the state employee plan, rather than be full-insured by private insurers, the state would achieve an upfront savings of $70 million dollars and give taxpayers, state employees and many small businesses greater control of their benefits.  A form of the Partnership first emerged in 2007 and was passed by the legislature last year before being vetoed by Governor Rell.  Despite the governor's previous opposition, advocates have continued to advocate for the plan across the state.

SustiNet: SustiNet, a parallel measure to the Partnership, would create an even more robust public plan to compete in the insurance market, and institute broader comprehensive health care reforms.  The bill would self-insure the state employee health plan and Husky (Medicaid) and create a new public plan available to small businesses and, importantly, individuals who lack access to affordable and quality employer coverage.  The new SustiNet plan would later be available as an option to larger employers in the state. 

Similarly stressing the "Obama-ready" theme and the compatibility of the Partnership and SustiNet, President of the Universal Health Care Foundation of Connecticut, Juan Figueroa, said, “Both bills will ensure Connecticut is first in the race for federal health reform resources. Fixing the health care system and economic recovery go hand-in-hand." Some key provisions of SustiNet inclue:

  • Unlike private insurance, all SustiNet applicants would be accepted regardless of pre-existing conditions and benefits would be comprehensive, including medical home services, mental health and dental care.  
  • To help ensure affordability, premiums would be subsidized based on income.  
  • To address the growth of health care costs and the quality of care, delivery system innovations are included that would influence change in private plans in Connecticut.  SustiNet is projected to cut the state's uninsured rate to 2% of the population, roughly 50,000 people. 

Economic modeling conducted for the foundation by Dr. Jonathan Gruber and The Urban Institute shows that delivery system changes and other cost control measures would significantly reduce the annual growth of health care costs, saving employers $1.35 billion, cutting individual health care costs by $540 million and bringing in an additional $800 million in federal matching funds to Connecticut.  While increased state revenues would be required to cover the cost of subsidies and raising provider rates in the Medicaid program to reduce the cost shift, households and employers would save nearly two dollars for every additional dollar spent by the state.

Public Insurance Plans are Nothing New:  SustiNet uses the choice of a public health insurance plan to ensure all residents have quality and affordable health care and to infuse the market with competition, as does the Healthcare Partnership.  If enacted, these proposals would go further than any state in creating the choice of a public plan for a wide range of health care consumers.  Bills modeled after the Healthcare Partnership surfaced this year in Iowa and New Hampshire, and proposals on a similar scale to SustiNet are being debated in at least Wisconsin, Washington, Oregon, and New York

Despite doomsday claims by the Right against the choice of a public plan, the idea of a public plan is not new to health care in the US, as we detailed in a recent Dispatch.  Along with Medicare, Medicaid, and the Veterans' Administration health program, states have created public plans that co-exist with and compete with the private market.  Thirty states currently offer state employees a public option side-by-side with private plans. And, many states have created public insurance choice for all children, most notably Illinois’ AllKids program.

While serving in the insurance industry capital of the world, Connecticut lawmakers have built the political will and public support to pass legislation creating the choice of a public health insurance plan.  This is a clear model for leaders in Washington DC to provide the same choice of a public plan as part of federal health care reform.

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New Jersey Lawmakers Send Permanent Absentee Voter Bill to the Governor

This week, the New Jersey legislature approved permanent absentee voting legislation [A 2451 by Rep. Joan Quigley and Sen. Raymond Lesniak] after minor reconciliation and scheduling delays kept the bill in a holding pattern for half a year.

In addition to giving voters the option to receive a mail ballot for consecutive elections with a single request, the bill also provides a new model for other states by offering all of its absentee voters the same process for voting by mail, including military and overseas voters.  This streamlined procedure should help make sure all ballots are counted and should make the job of handling mail ballots easier for election officials.

Fifth Permanent Absentee Voting State:  If Governor Corzine signs the bill, New Jersey will become the fifth state to provide a permanent absentee option for all voters, joining Colorado, California, Montana, and Washington, where the system has proven incredibly popular.  As we outlined in a Dispatch last month, increased access to voting by mail isn't just popular with voters, it also helps alleviate long lines at the polls and make sure that some voters aren't disenfranchised because they can't make it to the polls.  Sen. Lesniak saw a need for the bill because, he said, "[a]s New Jersey tries to get more people to exert their voice in government, we must make it easier for voters to vote on their own terms, rather than try to squeeze something else into what can be a hectic workday.”

Overall, voting outside the traditional polling place now accounts for almost a third of votes cast nationally.  In three of the four states that currently offer both early voting in person and a permanent absentee option to all voters, a majority of voters now vote by mail.  As more states adopt more permissive rules about voting by mail, it seems clear at this point that voter interest will grow across the country, propelling the further adoption of permanent absentee.

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Path Breaking Voter Registration Modernization Bill is Vetoed by Minnesota Governor Pawlenty

Minnesota legislators passed a landmark voter registration modernization bill recently that would, absent a veto, have registered or updated the registration of voters automatically when they applied for a driver's license, learner's permit or ID card.  It would also use information in motor vehicle and corrections databases to verify and maintain voter rolls.  This legislation, sponsored by Rep. Steve Simon and Sen. John Marty, would have made Minnesota the first state in the nation to proactively register voters, and made it among the most advanced in maintaining clean, accurate voter rolls.  The bill was designed to build on the state's already first-in-the-nation portability bill, which requires automatic updates to voter registrations based on changes of address.

However, Governor Pawlenty vetoed this historic legislation last week, citing his belief that "registering the [sic] vote should be a voluntary, intentional act."  His two sentence veto message was a pretty sad fig leaf on his basically saying "no thanks" to any more Minnesotans at the polls.  The governor didn't stop there when it came to saying no to model practices in election administration.  He also vetoed the two other pieces of election legislation that were sent to his desk.

Felon Re-enfranchisement:  S 763 by Sen. Mee Moua and Rep. Bobby Champion, would have put in place some very basic notice requirements on correctional facilities and probation officers related to informing people under their control when they have their civil rights restored.  The governor offered another myopic take on fundamental rights when he wrote that "citizens should bear some responsibility for being informed about their own situations and rights," again arguing that barriers to voting are good for Minnesota.

Omnibus Legislation:  This legislative session Minnesota conducted a statewide election recount to determine the winner of its US Senate race under intense scrutiny.  Partly in response to lessons learned from that experience and also addressing some long-recognized shortcomings, the legislature passed S 1331, by Sen. Katie Sieben and Rep. Ryan Winkler, to:

  • Consolidate absentee voting at the county level and refine procedures, a longtime goal of overtaxed local elections officials.
  • Move the mailing of absentee ballots to 60 days before an election to help prevent slow delivery from resulting in lost votes.
  • Replace signature matching with a unique identification number to verify voters.
  • Provide an online voter registration look-up feature for voters to confirm their registration through the Sec. of State's website.
  • Moving the state primary from September to August.

In his typically casual way of disposing with important legislation the governor vetoed the bill because it lacked bipartisan support, and he prefers the primary date to remain in September.  No mention was made of the many other important provisions listed above.

Sec. of State Mark Ritchie, the prime mover on Minnesota elections policy, believes his state "can and must always strive to make [its election system] more secure and cost-effective,” continuously improving what is widely considered to be the best election system in the nation.  Rep. Simon, who shepherded the voter registration bill through the legislature, and many of his colleagues have been consistently working to "make voting as easy and accessible as possible."  While the governor can delay their ability to do so with his vetoes, their record of accomplishment suggests that they will continue to make the case for common sense improvements, which will be adopted sooner or later.

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Research Roundup

Reports on policies to revive the economy:

  • Increases in minimum wage boost consumer spending - The recent increases in the federal minimum wage to $7.25 per hour that will be fully implemented by this summer has increased consumer spending by billions of dollars, according to the Economic Policy Institute.  This emphasizes that raising wages should be a key focus for policies to revive the economy.
  • Rural Workers Would Benefit from Unemployment Insurance Modernization - Because rural workers are more likely to work part-time, this Carsey Institute report argues they are likely to benefit from modernizing unemployment insurance to include part-time workers -- a key goal of the federal recovery plan's unemployment insurance spending requirements.
  • Federal Fiscal Relief Is Working As Intended: The Cases of New York and Virginia - These case studies by the Center for Budget and Policy Priorities on these two major states show that federal fiscal assistance is having its intended effect of enabling states to balance their budgets with fewer cuts in public services and greater support for anti-recession spending.

New reports on soaring insurance costs, insurance exchanges and stripped-down health plans:

How to Discuss Specific Social Justice Issues within a Human Rights Framework: Public Opinion Research Findings - This Opportunity Agenda report provides an in-depth analysis of public opinion polling on how Americans think about the idea of human rights in the context of modern policy debates, from how they think about health care as a "right" to who deserves to have human rights protected and who may not.

Majority Authorizations and Union Organizing in the Public Sector: A Four-State Perspective - This four-university report finds that, in four states where public employees can form unions by signing up a majority of workes (so-called "card check" procedures), the process works well and without any of the potential problems of employee coercion that are sometimes raised against the process.

Online Learning for Low Skill Adults - This report by Rutgers Center for Women and Work and CWA's Speed Matters documents the ways that innovative use of information technology—personal computers and high speed broadband—can be cost-effective in helping working adults expand their skills and move beyond entry-level jobs.


"Obama-Ready" Public Health Insurance Plans Approved by CT House

Connecticut Healthcare Partnership - H.B. 6582
SustiNet - H.B. 6600
House Leadership - Health Care Reform
Universal Health Care Foundation of Connecticut - SustiNet
Progressive States Network - State Public Health Insurance Plans are Models for National Health Reform

New Jersey Lawmakers Send Permanent Absentee Voter Bill to the Governor

New Jersey Vote by Mail Law
Progressive States Network - Voting by Mail and Before Election Day
Vote by Mail Project
Common Cause - Getting it Straight in 08: What We Know About Vote-by-Mail Elections and How to Conduct Them Well
National Network for State Election Reform - Importance of Universal Absentee Voting
Oregon Vote by Mail Procedures Manual

Path Breaking Voter Registration Modernization Bill is Vetoed by Minnesota Gov. Pawlenty

Minnesota Voter Registration Modernization Bill
Brennan Center for Justice - Voter Registration Modernization
Lawyer's Committee for Civil Rights - Voter Registration Modernization
Progressive States Network - Voter Registration Modernization


The Stateside Dispatch is written and edited by:

Nathan Newman, Interim Executive Director
Caroline Fan, Immigration and Workers' Rights Policy Specialist
Julie Schwartz, Broadband and Economic Development Policy Specialist
Christian Smith-Socaris, Election Reform Policy Specialist
Adam Thompson, Health Care Policy Specialist
Julie Bero, Executive Administrator and Outreach Associate
Austin Guest, Communications Specialist
Mike Maiorini, Online Technology Manager
Marisol Thomer, Outreach Coordinator

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