|
Introduction To The Connecticut Health Care Security Act
John R. Battista, M.D. and Justine A. McCabe, Ph.D.
Connecticut Coalition For Universal Health Care
January 9, 2001
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 insurer
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 utilizing the
insurance system created by this Act reveal these 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
may result from controlling the cost of medical procedures, emphasizing
preventive and primary care, coordinating medical services, establishing global
budgets for health care organizations, 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 which would result
from 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,
up to the amount they 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.
The health care payroll premium for employed individuals would be equal to or
less than the amount of money they would pay for comparable benefits under
current employer health insurance programs.
The health care premiums of the average self employed individual would be
equal to or less than the price of comparable private insurance. These premiums
would be collected through the state income tax.
There would be no health care taxes on families earning less than 185% of the
federal poverty guidelines.
The health care premiums of the average Medicare recipient would be equal to
or less than the cost of Medigap insurance to cover those benefits included in
this act, not covered under Medicare. These premiums would be collected through
the state income tax.
How Would The Health Care Insurance Be Administered?
A Connecticut Health Care Insurance Trust would pay all insurance claims.
Claim payment costs 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. The income of health care
givers would be sustained.
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 Connecticut income tax.
| 
