“As health care costs have grown, small businesses have had to drop and cut coverage or sacrifice job growth,” Speaker Donovan said. “Some can’t attract and retain talented employees because quality health insurance is unaffordable. We need to determine how to make health insurance for small businesses affordable, but also easily comparable, available, accessible, and meaningful.”

Speaker Donovan has assembled the Working Group on Small Business Health Care, comprised of small businesses and legislators, to examine obstacles and opportunities for small business owners seeking to purchase health insurance coverage for their employees and their own families. The group will be led by State Rep. Robert Megna, chair of the Insurance Committee.

The Speaker has charged the working group with reviewing small group insurance regulations, the market’s current offerings, the barriers that small business owners face when attempting to secure quality affordable health coverage, the impact of health insurance access on job growth in this sector, and alternative health insurance models. The group will assemble a set of legislative recommendations on how best to address the health insurance needs of the small business workforce.

Rep. Megna said, “As a small business owner and longtime advocate for quality, affordable health care, I am excited to partner with other business leaders to identify solutions to ever-rising health insurance costs. Health care costs are a major hurdle to job growth, and I’m honored that Speaker Donovan has chosen me to chair this important working group at a time when we are looking to our small businesses to lead our economic recovery.”

Members of Speaker Donovan’s Small Business Health Care Working Group include:

Legislative Members:

Small Business Members:

Charles Beyer, Beyer Precision, LLC. Charles Beyer is the president of Beyer Precision, LLC., a screw-machine manufacturing company located in Wolcott, CT.

Michael V. Brown, New Standard Institute. Michael V. Brown is the President of New Standard Institute of Milford, a training and consulting firm specializing in industrial maintenance.

Richard Carbray, Apex Pharmacy. Richard Carbray is the co-owner of two independent pharmacies, Apex Pharmacy and Home Health Center and Annex Pharmacy, both in Hamden.

Brenda Cerezo, Cerezo New Image Salon. Brenda Cerezo has owned Cerezo New Image Salon in Stamford for sixteen years. She is also a co-founder and former president of the Connecticut Hispanic Chamber of Commerce.

Jennifer Clark, Realtor, First Choice Realty. Jennifer Clark became a REALTOR®  ten years ago after working in the technical branch of banking for 18 years. She has also been a stained glass artisan for 34 years and currently operates Willimantic Art Glass Studio.

Attorney Chris Donohue, Riefberg, Smart, Donohue and NeJame, PC. Christopher T. Donohue, is a partner in the Danbury, Connecticut law firm of Riefberg, Smart, Donohue & NeJame, PC.

Kevin Galvin, Connecticut Commercial Maintenance. Kevin Galvin has been a small business owner for thirty years. He owns Connecticut Commercial Maintenance, Inc., a Hartford-based service company with four employees.

Jerry Hardison, West End Eye Care. Dr. Jerry Hardison has been an owner/member of West End Eye Care, LLC in Hartford since 1978.

Carolyn Malon, Family Dental Care of Farmington. Dr. Carolyn Malon is a private practice dentist, in partnership with her husband, Stephen Moran at Family Dental Care of Farmington.

Séan Moore, Greater Meriden Chamber of Commerce. Séan W. Moore has served as president of the Greater Meriden Chamber of Commerce since 1998.

John Pakutka, Cresent Group Consulting. John Pakutka is Managing Director of The Crescent Group, an advisory services firm with expertise in health policy, politics, litigation, and management.

John Seiffer, Better CEO. John Seiffer has been an entrepreneur for over 30 years. He has coached business owners since 1994 and became president of the International Coach Federation in 1998 and began consulting with entrepreneurs in 1999.

Linda St. Peter, Realtor. Linda St. Peter is the Broker/Owner of IBIS Consortium - Commercial & Investment Real Estate in Rocky Hill, Connecticut and an international speaker, instructor, and facilitator with Dynamic Directions, Inc.

Angel Reyes, Check Cashing and More. Angel Reyes has owned and operated Check Cashing and More in Bridgeport for over 10 years.

Lesley Waldron, IPS Limited & IPS Physician Services. Lesley Waldron is the owner of IPS Physician Services and owner/president of IPS Limited, two Bethlehem, Connecticut-based businesses.

Cornell Wright, Parker Wright Group. Cornell N. Wright is the principal of the Parker Wright Group, Inc., a management consulting practice, located in Stratford, CT, that specializes in--customer service, SWOT analysis, organizational assessments, strategy development and non profit board development.

New federal rules under national healthcare reform championed by President Obama eliminate insurance co-payments and deductibles effective August 1, 2012 for certain coverage including birth control, STD screening, and domestic violence counseling. Speaker Donovan sees the change as a victory for women’s health and said more must be done to combat higher costs of health insurance for women.

“This is a major positive change in healthcare policy that greatly improves women’s health coverage and will reduce costs in the long run because it is an important step forward in preventative care,” said Donovan. “We must aggressively continue to work in the 2012 legislative session to further reduce cost inequities of healthcare coverage between women and men.”

Connecticut first mandated health insurance coverage for birth control in 1999. This year the legislature required coverage for a full breast MRI for women with dense breast tissue. The legislature has also banned “drive by” deliveries and mastectomies and ensured direct access to OB-GYN care.

“Requiring insurers to provide birth control coverage for women free of charge is a welcomed development,” Rep. Willis said. “Reproductive health care should be available for all women. The enhanced health program also includes coverage for education and counseling which is an important provision of the plan.”

“We commend HHS on these regulations. The elimination of co-pays for these preventive services is a huge step in removing a financial obstacle that millions of American women face in getting the quality healthcare they need and deserve. We want the women of Connecticut to know that we’re here, we’ve been here, and we will continue to provide the preventive care they need,” said Judy Tabar, President & CEO of Planned Parenthood of Southern New England.

According to NARAL, 98% of all women in the U.S. have used birth control at some point in their lives.

“This new policy is a significant victory for women’s healthcare,” said NARAL Pro-Choice Connecticut Executive Director Christian Miron. “Ending co-pays for basic family planning services will put birth control within women’s financial reach and will allow a woman to choose the birth control method that she and a medical professional agree works best for her.”

“The new federal rules implement an evidence-based approach to women’s health. Co-pays create barriers that put routine and preventive care, including reproductive services and screenings, out of the reach for too many women in our community. Eliminating these hurdles will enable women to meet their unique health needs and stay healthy,” said State Representative Michelle Cook (D-65th District)

Speaker Donovan also said recent insulting comments by news commentators comparing birth control and domestic violence counseling to pedicures and manicures as well as a public statement by Republican Congressman Steve King of Iowa that free birth control coverage will “wipe out generations” showed that a gender-biased culture still exists regarding women and healthcare.

Senate Bill 11 called for a number of requirements for individual and small group health insurance companies. Changes included: increasing the amount of time required before a new rate can take effect, requiring a symposium on a rate filing if certain criteria are met, and mandating the Insurance Department post rate filings on its website and provide a 30-day public comment period.

Under an agreement reached between the executive and legislative branches, the Office of Health Advocate (OHA) can request that the Commissioner hold a hearing for rate increases of at least 15 percent or more on individual and small group HMO plans. The collaboration allows for up to four hearings a year while the Commissioner can exercise his current broad statutory authority to hold hearings on other health products, including long term health care policies, if necessary. Additional changes could be discussed next year.

“The General Assembly overwhelming approved Senate Bill 11 because its members believe in the importance of changing the way rate hikes are approved,” said Senate President Donald E. Williams, Jr. (D-Brooklyn). “The Governor shares our concerns and is working with us to immediately improve the process.”

House Speaker Christopher G. Donovan (D-Meriden) said, “We passed this bill after hearing from thousands of residents facing unconscionable increases in their insurance premiums—small businesses, self-employed individuals and those looking for work—folks who have no leverage to negotiate with the big insurance companies. That is why I am pleased that Governor Malloy and Commissioner Leonardi have agreed to a compromise that will allow public hearings and the participation of the Healthcare Advocate in the rate approval process.”

“Disagreement over the specifics of certain legislation is inevitable, but fortunately we all agree that there must be greater transparency in the rate approval process,” said Senator Majority Leader Martin Looney (D-New Haven / Hamden). “I’m pleased that we’ve been able to work with the Malloy Administration and begin work on a compromise that will benefit consumers and enhance close scrutiny of proposed health insurance increases.”

“This compromise will ensure that consumers have a voice in proposed insurance rate increases without compromising the health and competitiveness of the state’s insurance industry,” said Governor Dannel P. Malloy. “Particularly as the state works to implement federal healthcare reform, it’s important that we strike that delicate balance.”

State Senator Joseph J. Crisco (D-Woodbridge), Senate chair of the legislature’s Insurance and Real Estate Committee, said “To me it just seems like common sense that approval for any rate increase should be granted in conjunction with a requirement that insurance companies or the Insurance Department maintain and make available better records and subject the applicant to some measure of public scrutiny,” Senator Crisco said. “The agreement we've negotiated represents a first step toward greater transparency and better access to application materials in Connecticut's insurance rate approval process."

State Rep. Robert W. Megna (D-New Haven), House chair of the Insurance Committee, said, “We have heard from many concerned consumers and advocates about this veto. People get sticker shock when they see their annual premium increases. It is crucial that people get notice of excessive increases and an opportunity to have a say in the state’s consideration of these rates. I am glad to see the Insurance Department will be connected to the public in making these decisions.”

“I want to thank Senate President Williams, Senators Crisco and Gerratana, and all who voted for this landmark legislation.

“The Healthcare Partnership and Sustinet have been designed to work together as coordinated steps in health care reform. By allowing towns and non-profits to join the state health care system the Partnership provides an important foundation for the broader reforms that Sustinet will create in the future.

“Municipalities and non-profits will be able to take advantage of the increased bargaining power and reduced administrative costs associated with the state plan. Connecticut now joins at least 24 other states that allow local government employees to participate in the state employee plan.

“This legislation also will stimulate our economy. Employee benefits are one of the largest expenses faced by our cities, towns and non-profits. This plan would allow these entities to take advantage of good health care while providing financial relief to balance their budgets.”

“As we have argued for the past several years, this legislation will move Connecticut further on the path to quality, affordable healthcare for all,” said House Speaker Christopher G. Donovan, who has been a chief proponent of health care reform in Connecticut.

He added, “The Healthcare Partnership and Sustinet have been designed to work together as coordinated steps in health care reform. By allowing towns and non-profits to join the state health care system the Partnership provides an important foundation for the broader reforms that Sustinet will create in the future.”

Under the bill, municipalities and non-profits will be able to take advantage of the increased bargaining power and reduced administrative costs associated with the state plan. The state comptroller will offer the option to municipalities for enrollment beginning July 1, 2012 and non-profits for enrollment starting January 1, 2013.

At least 24 states allow local government employees to participate in the state employee plan.

"Hard work and persistent effort has ultimately resulted in a comprehensive bill that moves Connecticut closer to accessible healthcare for all," said State Rep. Betsy Ritter (D-Waterford, Montville), chair of the Public Health Committee. "This process has been extremely challenging, but I am pleased to see we are making progress in our commitment to provide viable options for those in need. I thank my colleagues and Speaker Donovan for his leadership on this bill and also all the people that helped make this happen."

 “Similar to shopping at a wholesale store, buying health care in bulk saves consumers money—it’s the power of numbers,” Speaker Donovan said. The Partnership expands on the successful prescription drug pooling initiative from last year, which is already saving money for some municipalities by allowing them to take advantage of the state’s bulk purchasing power. The City of Harford will save $1.8 million per year by joining the state prescription plan. In turn, the state will save $6 million through Hartford’s participation.

Speaker Donovan said the state employee health plan has been providing good benefits to employees while keeping cost increases to a minimum, in large part due to the efforts of the state’s health care cost containment committee, which would continue to oversee the plan under this proposal.

The legislation, he said, will also stimulate our economy. “Employee benefits are one of the largest expenses faced by our cities, towns and non-profits. This plan would allow these entities to take advantage of good healthcare while providing financial relief to balance their budgets,” he said.

The provisions in the bill move the state toward Connecticut-specific health care reform that improves health care delivery, controls costs and results in savings and better health outcomes by:

• planning for a multi-payer database
• improving data collection at DPH
• establishing the Office of Health Reform and Innovation
• developing mechanisms for expanding access to insurance when the individual responsibility requirement takes effect in 2014
• identifying non-state funding sources to facilitate implementation of the federal healthcare reform
• coordinating Medicaid enrollment planning with the Exchange
• convening a consumer advisory board
• establishing the SustiNet Healthcare Cabinet to advise the Governor on development of an integrated health care system and a business plan for expanding coverage through private or public mechanisms; implementing a Basic Health Program for people 133-200% FPL; and convening working groups on health care system reforms, such as multi-payer initiatives, medical homes and electronic health records.

With this legislation, Speaker Donovan said, Connecticut will be able to attract new federal health care dollars; put in place more effective and sustainable ways to deliver health care, improve quality and expand coverage; provide affordable state options for residents; and implement delivery system and payment reforms to move toward a more coordinated, patient-centered, evidenced-based approach to health care that improves quality and slows cost growth.

“Pooling gives municipalities and non-profits the chance to realize important cost savings while providing families in our state with greater access to quality, affordable health care,” Speaker Donovan said. “In addition, the state will see relief that will help us continue our economic recovery.”

Speaker Donovan cited a prescription drug pooling bill that became law last year under which the City of Hartford expects to save $1.8 million in annual employee prescription costs by coming into the pool. The addition of Hartford employees to the state’s plan would also result in a savings of $6 million per year on the part of the state.

“We’ve been talking about pooling opportunities for a number of years,” he said. “Now, with a Democratic Governor who understands how this initiative can help families, our cities and towns, non-profits and the state, we have a chance to pass legislation that will make a real difference in people’s lives.”

“We are here tonight to boldly raise our voices. We want to let the governor and the legislative leaders of our state know that we want them to keep SustiNet moving forward,” said Juan A. Figueroa, president of the foundation. “That means making sure the way is paved for a public option that meets the needs of small businesses and residents in a timely fashion.”

The foundation was joined by other proponents of the SustiNet health care reform bill at Union Station, where the proposal was launched in January 2009. It was voted into law through a veto override in July of that year. Rally organizers Wednesday night said they also wanted to urge Gov. Dannel Malloy to reclaim his promise to deliver on health care reform by clearing the way for the implementation of SustiNet’s public option at the appropriate time and in a fiscally responsible manner.

“SustiNet is a centerpiece of that promise,” said Linda St. Peter, a member of the Connecticut Association of REALTORS, one of the more than 15 statewide organizations that comprise the SustiNet Leadership Network, whose members attended the event. “We are well aware of the fiscal challenges and an affordable health care option for small businesses and independent contractors is part of the solution.”

Gov. Malloy was invited to the rally. Speaker of the House, Christopher Donovan, Senate President Pro Tempore, Don Williams, and the co-chairs of the Public Health Committee, Rep. Betsy Ritter and Sen. Terry Gerratana, were among the lawmakers that addressed the gathering. Donovan told the crowd, “We have in place a framework that will provide the next steps for SustiNet to move us in the direction of expanding access, improving care and achieving cost savings.”

“By controlling costs, we help families and can encourage small businesses to create jobs.” Donovan said, “We’re going to continue to work with the supporters of health care improvements and SustiNet here in Connecticut to make reform stronger and stronger. We need to do what’s in the best interests of all of Connecticut’s residents.”

Ritter said while she is disappointed the SustiNet proposal has been modified, she is pleased to be working with the governor and the people from around Connecticut to keep moving health care forward. “Through these efforts, our state will be better poised to take advantage of opportunities in the federal health care reforms, bringing affordable health care closer to reality.” She said, “ Increased job opportunities for the state, helping small businesses thrive and grow, and building a stronger economy are just some of the advantages we can look forward to.”

Rally goers marched through Bushnell Park to the North steps of the Capitol and delivered personal cards from SustiNet supporters to the governor.

In addition to the Connecticut Association of REALTORS, other members of the SustiNet Leadership supporting the event:

AARP Connecticut
League of Women Voters of Connecticut, Inc.
National Physicians Alliance
Connecticut Association of REALTORS, Inc.
American Cancer Society
Interfaith Fellowship for Universal Health Care
Connecticut Nurses’ Association
Christian Community Action, Inc.
Small Business for a Healthy Connecticut
National Association of Social Workers/ Connecticut Chapter
Greater Meriden Chamber
Connecticut Center for a New Economy
Legal Assistance Resource Center of Connecticut, Inc.
AFSCME Council 4
Christian Activities Council
Connecticut Citizen Action Group

WILLIMANTIC — Three state lawmakers and more than 30 people discussed health-care issues at a forum held at Generations Family Health Center’s Windham Mills location Friday.

The forum, hosted by the Caring Families Coalition of Connecticut, featured local Rep. Susan Johnson D-Willimantic, Gregory Haddad D-Mansfield and Betsy Ritter D-Waterford.

While legislators highlighted proposals at the state level involving health care — including SustiNet and the Connecticut Healthcare Partnership proposal — others spoke about what they’d like to see change with health care.

“We need health- care reform desperately and we need it now,” said Richard Mackowiak, of Eastford, while speaking about his frustration in dealing with health insurance companies.

Mackowiak said he pays about $24,000 annually for family coverage as a self-employed hydroelectric engineer, and that he doesn’t require any special care other than routine checkups.

He said he had been denied coverage due to a “pre-existing condition” and that his wife had also been rejected as well for fibromyalgia.

Mackowiak said he spoke to the insurance company about the denial, ant it gave the example of purchasing a car with a bad transmission.

He said the insurance company explained that with a car with a bad transmission, one wouldn’t be able to purchase warranty insurance.

“I was furious,” he said, adding that the insurance company was basically telling him that it was time to trade in his wife.

Mackowiak said insurance companies and those who are insured have two different goals — insurance companies want to make money while those insured just want coverage. “We need to do something now,” he said.

All three legislators discussed creating a pool to achieve savings and spread the risk over a larger population.

“We do need a public option,” Haddad said, “A non- profit option.”

Haddad spoke of SustiNet, which would coordinate the state’s health-care spending, with the hope of improving quality and slowing cost increases.

SustiNet would leverage the state’s existing health- care programs and federal dollars to create a non-profit health insurance choice for municipalities, private employers and households.

Haddad said the insurance program would also need to compete in the marketplace.

Ritter said SustiNet would compete with private insurance plans and that competition would increase the quality of care and decrease costs.

“We all win,” she said, as a result of competition in the marketplace.

Ritter also pushed for better coordinated care and said back then, her primary doctor had all her information in a folder.

Johnson spoke of the healthcare partnership proposal or the so-called pooling legislation.

She said it has been in the works for a while, and she hopes it can pass through to Gov. Dannel Malloy’s desk for signature.

The pooling legislation would allow municipalities, non-profits and small businesses to purchase insurance through the state employee health plan.

Others offered comments.

Joyce Rawitscher, of Storrs, said she was concerned about discussions at the federal level, worrying about the possibility of “horrible in-roads” into Medicare and Medicaid.

“I’m just very worried about these programs as they exist,” she said, adding she’s concerned about the fiscal situation becoming more dire.

Lynne Ide, director of advocacy for the Universal Healthcare Foundation of Connecticut Inc., said originally Malloy had supported SustiNet, however, his office appears to be concerned about the high cost numbers that were released by the state’s Office of Fiscal Analysis.

That office estimated SustiNet would cost hundreds of millions of dollars a year.

However, Ide said the conversation needed to shift into whether it was worth investing $3 million to save $50 million in 2014.

She also urged people to turnout for a rally for SustiNet, which will be held on April 27 at 6 p.m., at the Hartford Train Station at Union Place in Hartford.

Al Malpa

Taking questions from the audience at a forum on SustiNet and health care are state Rep. Gregory Haddad, D-Mansfield, state Rep. Betsy Ritter, D-Waterford, and state Rep. Susan Johnson, D-Willimantic. The forum was organized by the Caring Families Coalition.

STATE REPRESENTATIVE ELIZABETH B. "BETSY" RITTER
"SustiNet's primary strategy for slowing cost growth is overhauling Connecticut's health care delivery and payment systems. The fiscal note highlights the power of numbers to leverage health care innovation -- measures that encourage care coordination and electronic medical records -- to create savings, potentially $58.5 million for health care the state purchases."

The bill would permit municipalities, non-profits and small businesses to purchase employee health insurance through the state employee plan, creating a large pool of insured lives with increased bargaining power and lower costs.

“The pooling bill can provide families in our state with greater access to quality, affordable health care,” Speaker Donovan said. “Further, it can provide economic relief to the state, our towns, small businesses and non-profits at a time of need. This bill will provide relief from the unpredictable rate hikes employers experience from year to year by giving them access to the stability of the large state pool.”

Speaker Donovan cited a prescription drug pooling bill that became law last year that is being considered by several municipalities across the state as a cost saving measure. The City of Hartford, for example, expects to save $1.8 million in annual employee prescription costs by coming into the pool. The addition of Hartford employees to the state’s plan would also result in a savings of $6 million per year on the part of the state.

“In these challenging economic times, we have come to understand that health care is a vital economic issue,” Speaker Donovan said. “It is so for individuals and families across our state, and it also is so for municipalities and businesses large and small. Access to affordable health care can mean choosing to become an entrepreneur, the difference of hiring an employee or being able to retain experienced employees and provide quality services.”

He also said that the economic issues posed by rising health care costs are a significant obstacle to business growth in Connecticut.

Speaker Donovan’s comments came in a morning press conference at the Legislative Office Building and at a public hearing before members of the three legislative committees – Insurance and Real Estate, Human Services and Public Health.  [Speaker Donovan’s complete testimony.]

There, he made comments about four bills currently before the legislature:

• CT Healthcare Partnership (HB 6308) – Speaker Donovan has been the chief champion of this legislation which twice passed the General Assembly but was vetoed by Governor M. Jodi Rell. “It is more important than ever now,” he said, “because municipal health care costs have continued to spike each year – far beyond the rate of inflation. And heads of businesses continue to tell us that rising health care costs are limiting their ability to expand and grow. Access to affordable healthcare can mean hiring an employee, choosing to become an entrepreneur, or being able to retain experienced employees and provide quality services.”

• SustiNet (HB 6305) – “This program changes the way the state delivers healthcare,” Speaker Donovan said, “and offers new insurance choices to non-profits, businesses and individuals. SustiNet builds on the strength of healthcare pooling to increase purchasing power, lower costs and expand access to people of all health histories. It will maximize the potential of federal reform, spend state healthcare dollars more efficiently, improve quality, and offer employees and families a new health insurance choice that reforms healthcare delivery and slows cost growth throughout the entire insurance market.”

• Federal Health Reform Implementation: Exchange (HB 6323) – Speaker Donovan said this bill “helps individuals and small businesses access more options, is good for businesses because employers will spend less time and money buying their health insurance - -they can go directly online and compare apples to apples. Too often small and municipal employers aren’t given choices – with the exchange they can see the universe of options, understand them, and purchase them online at their convenience.”

• State Prescription Drug Purchasing (HB 6322) – Speaker Donovan said, “This bill is another great example of using the size of the state employee pool to leverage greater discounts for other healthcare purchasers. HB 6322 would enable the Comptroller’s Office to amend its existing prescription drug purchasing contract to include the Medicaid, Husky, ConnPACE and Charter Oak programs. The Comptroller’s office estimates that by implementing this innovative streamlining measure, the state will save $66.5 million annually—without harming prescription coverage for some of the state’s most vulnerable residents.”

Led by Public Health Committee House Chair, State Rep. Betsy Ritter (D-Waterford/Montville), Insurance House Chair, Rep. Robert Megna (D-New Haven) and Rep. Peter Tercyak (D-New Britain), Human Services House Chair, the agenda will include the following bills:

• HB 6308 (RAISED) AN ACT ESTABLISHING THE CONNECTICUT HEALTHCARE PARTNERSHIP.

• HB 6305 (RAISED) AN ACT CONCERNING IMPLEMENTATION OF THE SUSTINET PLAN.

• HB 6323 (RAISED) AN ACT MAKING CONFORMING CHANGES TO THE INSURANCE STATUTES PURSUANT TO THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT, AND ESTABLISHING A STATE HEALTH PARTNERSHIP PROGRAM.

• SB 921 (RAISED) AN ACT ESTABLISHING A STATE HEALTH INSURANCE EXCHANGE.

• HB 6322 (RAISED) AN ACT CONCERNING STATE PRESCRIPTION DRUG PURCHASING.

Sign-up will begin at 8:30 A.M. in the First Floor Atrium of the LOB. The first hour of the hearing is reserved for Legislators, Constitutional Officers, State Agency Heads and Chief Elected Municipal Officials. Speakers will be limited to three minutes of testimony. Bills will be heard in the order listed in the Bulletin. Unofficial sign-up sheets have no standing with the Committees.

Speaker Donovan said legislation passed in recent years under the Human Services Committee leadership of state representatives Peter Villano (D-Hamden) and Toni Walker (D-New Haven) would have provided residents and the state with similar benefits earlier but implementation was stymied by the Department of Social Services. He said the legislature anticipated savings of $60 million through a change in health care administration of Medicaid programs, and another $12 million by moving the HUSKY B program to the ASO model. Additional savings could be achieved through an enhanced federal match on the Money Follows the Person initiative.

“With new leadership in the executive branch, the people of Connecticut can begin to realize some of the real benefits of health care reform,” he said. “Our goals in health care have always been clear – quality care at affordable costs. Working together, our residents can now look forward to better care while the state realizes substantial savings.”

“Battling MCOs over coverage can be daunting and overwhelming for families,” Rep. Walker said. “For years, we have been working to provide families a more comfortable health care experience. And that is achieved through consistency – having a familiar doctor to rely on for your health care.  With the ASO and PCCM model, you will deal with your doctor and your children’s pediatrician, not a faceless insurance company.”

The SustiNet Board’s Final Report includes recommendations for:

• Implementing a delivery system and payment reforms to move toward a more coordinated, patient-centered, evidenced-based approach to health care that improves quality and slows cost growth.
• Integrating these improvements first over publicly-administered health plans, including state employees and retirees, Medicaid and HUSKY beneficiaries to bring savings to taxpayers.
• Leveraging the power of existing state programs and federal dollars to provide a new health insurance choice for municipalities, private employers and households.

“Being here today and discussing SustiNet legislation we just raised in our committee is a huge milestone,” Ritter said. “We have been working together with an extraordinary group in the SustiNet Board that was formed to bring forth recommendations that would allow us to draft a comprehensive bill, and I am pleased to have accomplished one of our immediate goals. I hope you will continue to be involved in this process—come to the public hearing and help us make the case for this important legislation.”

According to the Board’s report, the SustiNet proposal would save Connecticut taxpayers between $226 million and $277 million annually, beginning in 2014. By slowing health care cost growth even 1% per year, SustiNet would have a $355 million positive impact on the state budget in 2014, with gains reaching more than $500 million a year starting in 2019.

“The SustiNet plan will be able to compete in the new insurance exchange when it rolls out in 2014, providing residents with a quality affordable option at a time when more residents will be seeking insurance,” Speaker Donovan said. “This proposal will allow the state to slow cost growth in existing healthcare programs and stretch new federal health reform dollars even further.”

“Connecticut is very fortunate to have in place the building blocks for SustiNet, to help streamline healthcare delivery in our state and make our programs more receptive to new federal healthcare guidelines,” Senator Edith G. Prague (D-Columbia) said. “As the undisputed single most expensive portion of our state budget and with daunting projected budget deficits, there is no better time to make an efficient healthcare delivery system a priority in our state.”

Kevin Galvin, Small Business for a Healthy CT stated, "Small businesses need health care reform to sustain them and grow. SustiNet allows Connecticut's small businesses to provide quality, affordable health insurance. It's the right thing to do."

Comptroller Kevin Lembo, Chair of the SustiNet Board was unable to attend the event, but issued the following statement, “I commend the state General Assembly’s Public Health Committee for moving state health care reform forward – positioning Connecticut to save hundreds of millions in state health care dollars, while increasing access to affordable and quality health care for all state residents.”

To view a copy of the full SustiNet report please go to:  www.ct.gov/sustinet/lib/sustinet/sn.final_report.appendix.cga.010711.pdf

“We would like to thank Connecticut’s Congressional Delegation for standing up for quality, affordable health care for Connecticut’s working families. Under federal health reform, our constituents are already seeing better access to affordable care, an end to arbitrary lifetime limits on benefits and denials without a chance of appeal. In addition, our state is taking advantage of millions of new health care dollars for Medicaid and retiree health insurance. We stand behind our delegation as they stand up to the special interests and putting Connecticut’s people before insurance industry profits.”

Speaker Donovan said he was pleased to see that the report recommends allowing municipalities to join the state employee plan as soon as possible and providing new options for small businesses and non-profits.

According to the report, implementing health reform according to the board’s recommendations will save Connecticut taxpayers between $226 million and $277 million annually, beginning in 2014. These savings result from substituting newly available federal dollars for current state spending.

Further, the report maintains that if SustiNet’s system and payment reforms succeed in slowing cost growth even 1% per year, the state budget will improve by $355 million in 2014, with gains reaching more than $500 million a year starting in 2019.

“I was also pleased to see that the public SustiNet plan will be able to compete in the new insurance exchange when it rolls out in 2014, providing residents with a quality affordable option at a time when more residents will be seeking insurance,” Speaker Donovan said. “This proposal will allow the state to slow cost growth in existing healthcare programs and stretch new federal health reform dollars even further.”

“I would like to acknowledge and thank the dozens of health professionals and advocates who volunteered their time and expertise over the previous sixteen months to make a difference for Connecticut’s families and businesses who struggle every day with the high costs of health care,” he said.

“Today, health care consumers in Connecticut have won a major victory in the ongoing battle against insurance company abuse,” Speaker Donovan said. “Those who hold individual policies due to unemployment, self-employment or employment by small businesses cannot access affordable coverage in this economic climate, and a 20 percent increase would simply have been too much to bear.”

Speaker Donovan had submitted comments for the record at the Insurance Department hearing on the rate increase request last month saying, “The insurance industry has proposed more shocking double-digit increases, even as insurance companies report record-breaking profits. If we do not take action to rein in health insurance companies, provide more affordable options, and protect consumers from abusive insurance company practices, families and businesses will continue to be crushed by rising health care costs.”

“As surprised as I was to learn of the Insurance Department’s approval of Anthem’s outrageous request for an increase on individual policies last month—I am equally dismayed by the request you are considering today,” Speaker Donovan wrote in comments submitted for the record at an Insurance Department hearing on Anthem’s application.

“This request is especially unconscionable because it affects many people who hold individual policies due to unemployment, self-employment or employment by small businesses that can not access affordable coverage, especially in the current economic climate,” he wrote of Anthem’s request for an average 20 percent increase to individual-market health plans that are exempt from the requirements of federal reform.

Speaker Donovan wrote, “The insurance industry has proposed more shocking double-digit increases, even as insurance companies report record-breaking profits. If we do not take action to rein in health insurance companies, provide more affordable options, and protect consumers from abusive insurance company practices, families and businesses will continue to be crushed by rising health care costs.”

Speaker Donovan noted that the federal government has said the impact of health reform on rates will only be 1-2%, “offset by provisions that save us all money. In stark contrast, Anthem requested, and the department approved, a 47% rate hike on individual policies affected by health reform in October—a decision that amounts to writing a blank check to the insurance industry—at the expense of consumers.

“While today Anthem is attributing the need for a rate increase to rising medical costs, prior rate increases have not resulted in increased provider reimbursement rates to cover these costs. Instead, Anthem asks patients to shoulder a bigger cost share without increasing payments for actual medical care.”

Speaker Donovan said the recent spate of rate hikes highlights weaknesses in the Insurance Department’s process for scrutinizing rate increase applications, particularly current law that permits insurance company requests for premium increases to pass into effect after 30 days with no requirement for a public hearing or affirmative approval of these requests by the Insurance Department.

He cited a December 2009 report from the non-partisan Office of Legislative Research that documented the frequency of insurance company rate requests and Insurance Department rate approvals on individual policies in the last several years.

“Each of the eleven most recent rate increase requests on individual policies were approved by the Insurance Department,” he wrote. “Eight of these proposals were in the double-digits and nine of the requests were approved as filed, leading many consumers and state officials to question the level of scrutiny applied by the Department in examining whether the rates are ‘excessive’ or ‘unfairly discriminatory’ as is required by statute.”

Speaker Donovan argued for reconsideration of legislation that would hold insurance companies accountable for premium rate hikes.

Such legislation, he said would:

• require the Insurance Department to take affirmative action on rate increase applications
• require insurance companies to notify policyholders of requests for rate increases and disclose supporting documentation for public scrutiny
• require that rate requests be certified by an actuary that they are in compliance with the law and not excessive
• empower the Attorney General and the state Healthcare Advocate to access rate request documentation and be parties to hearings.

“It is my hope that the Insurance Department, the insurance industry’s regulatory authority in Connecticut, will support legislation that strengthens transparency and accountability for consumers in the rate review process going forward,” Speaker Donovan concluded. “Endless rate hikes are one of many examples of why we need a strong public option, such as opening the state health plan to small businesses and individuals, so they can get good health care without being subjected to insurance industry profit margins.”

“The federal government says the potential impact of health reform on rates will only be 1-2% – offset by provisions that save money for all of us.

“The commissioner’s decision is just another example of why we need a strong public option, such as opening the state health plan to individuals and small businesses so they can get good health care without being subjected to insurance industry profit margins.”

“Today, some of the worst health care coverage abuses in the insurance industry thankfully come to an end,” Speaker Donovan said. “With these reforms, consumers can take charge of their health care. They will realize improvements in coverage that will make a real difference in the lives of thousands of families here in Connecticut.”

Speaker Donovan’s comments were made at a press conference sponsored by Health Care for America Now (HCAN) in the Legislative Office Building in Hartford commemorating the six-month anniversary of the federal health care reform act.

He pointed to several reforms that take effect today. “No longer will insurers be able to deny coverage to kids with pre-existing conditions, or put lifetime limits on benefits,” Speaker Donovan said. “No longer can insurance companies deny claims without the chance for appeal, and no longer can they cancel policies without proving fraud.”

In addition, he cited three additional provisions that will benefit consumers:

• New health plans must cover preventive screenings without co-pay.
• Most health plans must now keep dependents on policy until age 26.
• Insurers cannot require prior approval or co-pays for use of emergency rooms.

Speaker Donovan said Connecticut’s partnership with the Obama administration and the state’s Congressional Democrats in Washington has already provided significant benefits for the state through the federal health care reforms.

Connecticut, he said, will save $53 million by July 2011 from rolling SAGA into Medicaid, with 45,000 adults eligible for the Medicaid program.

“The reform act is helping Connecticut seniors and businesses at a time when they need it most,” Speaker Donovan said. As of September 20, 13,000 Connecticut seniors have received $3.25 million in tax-free $250 checks to help them afford prescriptions, and 30,000 Connecticut small businesses will qualify for tax credits to help pay for employee coverage.

“Thanks to the implementation of SustiNet, Connecticut is uniquely positioned for future monies,” Speaker Donovan said. “SustiNet implementation will put our state in the position to better leverage federal funding, saving money for all payers.”