Introduction to The CT Health Care Security Act

John R. Battista, M.D. and Justine A. McCabe, Ph.D.
Connecticut Coalition For Universal Health Care (website)
December 18, 2000

What Would The Connecticut Health Care Security Act Do?

Provide comprehensive health care insurance for all Connecticut residents.
Insure payment for all health care services, medications, and medical equipment prescribed by a licensed health care giver without insurance pre-approval.
Allow free choice of any licensed health care giver.

What Would The Universal Health Insurance Cost?

Prospective studies from the Connecticut Office of Health Care Access, other states, and the federal government predict savings of up to 10% of current expenses. Comparisons with other industrialized countries with populations comparable to Connecticut which utilize the health care insurance system created by this Act reveal the predicted savings to be realistic and conservative. No studies predict increased costs.
Savings would result primarily from decreased administrative expenses, and purchasing medications and durable medical equipment in bulk. Additional savings can be expected from controlling the cost of medical procedures, emphasizing preventive and primary care, as well as educating and reviewing providers in terms of quality assurance guidelines. These savings would be partially offset by increased demand for medical services as a result of covering the uninsured and expanding insured medical services.
The Act mandates that any increases in budget must be less than the percent increase in the US health care costs for the preceding year following an initial adjustment period.

How Would The Health Care Insurance Be Paid For?

The State and federal governments would continue to pay at the current rate for those individuals eligible for state and federal programs.
Excise taxes on activities detrimental to health, such as cigarette smoking, would be collected up to the amount shown to contribute to health care costs.
All employers would pay a health care payroll premium for each employee. Large employers would pay at a rate equal to or less than their current average rate. Smaller employers would pay at a progressively lower rate depending on the number of their employees.
Employed individuals would pay, on average, a health care payroll premium equal to or less than the amount of money the average employee would pay for comparable benefits under current employer health insurance programs.
Self-employed individuals would pay, on average, health care premiums through the state income tax system equal to or less than the price of comparable private insurance for the average self-employed individual/family through private health care insurance.
There would be no health care taxes on families earning less than 180% of the federal poverty guidelines.
Medicare eligible residents would pay a health care premium through the state income tax system equal to or less than the amount of money the average Medicare recipient would pay for Medigap insurance to cover those benefits included in this act, not covered under Medicare.

How Would The Health Care Insurance Be Administered?

A Connecticut Health Care Insurance Trust would be created that would pay all insurance claims. Claim payment costs would be limited to 3% of revenues, in line with the Medicare system. All other administrative costs of the Trust would be limited to 3% of revenues.
State and federal health insurance programs for Connecticut residents would be consolidated into the Trust.
The Trust would be governed by a board of health care givers, health care advocates, health care organizations, tax payer groups, health care experts and public officials, reportable to state government.
Administration of the Trust would be the responsibility of a physician Executive Director who would administer five divisions of the trust concerned with 1) payments, 2) planning, research and development, 3) quality assurance, 4) public health education, and 5) direct health care services assumed from state health care programs.
The activities of the trust would be advised by a health care givers advisory council, a health care organizations advisory council, and a health care consumers advisory council.
Reimbursement rates for health care procedures and hospital expenses would be decided by the Trust in consultation with the health care consumer, health care givers and health care organizations advisory council. It is the intention of the act not to significantly impact the overall income of health care givers
The Trust would be a quasi-public agency, independent of state government, yet accountable to it.

How Would Eligibility Be Determined?

Employed individuals and their families would become eligible with their first employee and employer payroll premium.
All individuals eligible for state health care programs would be immediately eligible.
Self-employed and federally covered individuals would become eligible with the payment of their state of Connecticut income tax.
Enrollment costs for the first year would be paid for out of the state of Connecticut tobacco insurance payments. All future enrollment costs would be assumed by the Trust as part of its overall administrative expenses.