nothin Malloy, DeStefano Battle Over Universal… | New Haven Independent

Malloy, DeStefano Battle Over Universal Health Care

They both want it. The question: How to pay for it? As the other” Democratic primary race in Connecticut heads to the finish line Aug. 8 — the one that’s not Lieberman v. Lamont, but Dan Malloy v. John DeStefano for the Democratic nomination for governor — the focus on the candidates’ dueling plans for universal health coverage has moved front and center.

Malloy’s camp aired a commercial in early August showing DeStefano’s head on the body of a pregnant woman and a mother holding a baby to challenge his commitment to women’s health issues. (While some called the ad clever, it may have backfired, as many women protested that it was in poor taste, and it can’t be found on Malloy’s own website.) Then, over the weekend, some supporters from each camp picketed the other candidate’s headquarters over the issue.

The Universal Health Care Foundation of Connecticut is happy with both plans, says foundation president Juan Figueroa, knowing that whoever wins the primary will carry the issue forward to the general election and to Gov. Jodi Rell. Rell so far has not said much at all about what both Democrats call Connecticut’s health care crisis, and who has not yet presented her own plan.

The foundation’s position is that any viable plan for universal health care must be affordable, portable, provide access for all, and be economically sustainable by society. Figueroa says both plans meet these criteria, at least potentially (because they are concepts, not plans that have been operationalized). The difference is in how they are financed,” says Figueroa.

But as the race tightens to practically a dead heat and heads down to the wire, both campaigns are drawing all kinds of distinctions between their plans. Below are summaries of each plan, and critiques by each side of the other’s plan. (Full descriptions can be found here and here.)

Both plans rely on the foundation’s estimate that it would take $340 million to provide universal health coverage to all Connecticut residents, but they rely on different ways to find the money.

Funding

The Malloy Universal Health Care Plan seeks a waiver to permit raising the income eligibility limits for participation in Medicaid from 100 percent of the federal poverty level to 200 percent, generating $90 million in federal matching funds. Lisa-Joy Zgorski, Malloy’s press secretary, points to other states with Democratic governors who have gotten such waivers. And Malloy proposes expanding the existing Medicaid program further by creating Connecticut Universal” to offer coverage for all others who earn above that income level. His plan would also increase the cigarette tax to bring in another $100 million and collect $20-$30 million from corporations (see below).

DeStefano says Malloy’s two-tier” plan would not provide equal coverage for all, and is not truly portable because it would require families whose income levels change to move back and forth between the two levels of coverage. It’s continuous care,” Zgorski insists, and can be taken from job to job.” DeStefano’s campaign spokesman, Derek Slap, says the group most likely to be left out of Malloy’s plan are low-income single men.

DeStefano has criticized Malloy’s plan as dependant on President Bush’s generosity. Slap says no Democratic governor has gotten close to the number of waivers under the current administration that the state needs to pull off universal coverage. Zgorski says, It’s ridiculous to equate needing approval from the federal government with needing a personal favor from George Bush.”

Zgorski says having several building blocks, including but not limited to Medicaid expansion, is how many universal health care plans, including the Massachusetts plan passed this spring, are built. The leaders of the Democratic Party — Hillary Clinton, John Kerry, Ted Kennedy — have embraced this approach,” she says.

DeStefano’s plan, Connecticut Cover All Now! (Connecticut CAN!), is funded through closing corporate state tax loopholes.

The plan creates a Connecticut Consortium that allows everyone to maintain their health care coverage when they switch jobs or lose their jobs,” says Slap. It would cover low income adult males who might not be covered under Medicaid rules. The plan would require significant changes in the tax code to be approved by the legislature. 

Malloy’s camp ridicules DeStefano’s chances of pulling that off, but Slap says, We have a whole group of lawmakers who have already endorsed it, including all the top leadership except [Speaker of the House] Jim Amann, and they’ve all said they would make it a top priority” in next year’s legislative session.

Zgorski says the DeStefano plan would create a whole new bureaucracy, full of inefficiencies, rather than expanding upon a federal funding mechanism that’s been in place for decades. Slap shoots back that, in addition to the problem of needing a federal waiver, the Medicaid system is so underfunded now that many health care providers in the state won’t participate.

Women’s Health
Both plans would cover all mandated women’s health services. The controversy stems from the fact that DeStefano’s plan initially did not make that clear, and some interpreted his plan as possibly trading some mandates around women’s health to gain a funding source for his universal coverage.

In TV ads and phone calls made to likely Democratic voters, Malloy’s campaign is hammering on this issue, hoping to attract women voters.

Derek Slap says it’s a non-issue, but acknowledges the DeStefano campaign could have done a better job of explaining its position at first. There’s no connection between funding and mandates,” he says. Because the DeStefano plan would be universal, services such as hospital stays for Caesarian sections and mastectomies, cervical cancer screening and prescription contraceptives, would all be included, and thus there would be no need to mandate coverage separately.

Pay or Play vs. Free-Rider Fee”
According to a comparison of the two plans released by the DeStefano campaign, The DeStefano plan would eliminate state tax benefits and close corporate loopholes for companies like Wal-Mart that pass their health care costs onto taxpayers. The Malloy plan protects companies like Wal-Mart. The entire burden of universal health care is placed on workers and taxpayers. Not a single corporate tax loophole would be closed allowing companies like Wal-Mart to put their employees on public assistance while at the same time being eligible for corporate tax benefits.”

The Malloy campaign says this is one of DeStefano’s intentional misstatements.” Zgorski says, The Malloy Universal Health Care Plan will reduce the use of emergency rooms for unnecessary care and help control premiums by requiring companies that don’t provide health coverage to pay a hospital cost-sharing fee if a significant number of their employees rely on free hospital care for health problems that could have been prevented.”

Specifically, its free-rider fee” will be triggered if, over the course of a year, more than 20 percent of a company’s employees receive free care, or if the free care costs the state over $50,000. Fees will range from 10 percent to 100 percent of the cost to the state depending on the severity of a company’s over reliance on taxpayers’ dollars to provide care to their employees. This free-rider surcharge is a simple and effective way to ensure accountability and fairness.”

Juan Figueroa of the Universal Health Care Foundation says, Malloy’s reliance on federal money is not that unusual; the Massachusetts proposal just did that.” However, Slap points out that Massachusetts has a Republican governor, Mitt Romney. 

DeStefano is looking at closing corporate tax loopholes,” Figueroa continues. It’s untested, but states will have to become creative about financing because ultimately it will be a mix and match of various resources.”

Speaking of the two plans, he concludes, Because they are concepts and the numbers have not been run, there are a lot of unknowns. It’s hard to criticize the plans without doing a lot more research. Both candidates are talking about their intent to cover everyone, so if their models need to be adjusted so that everyone is covered, I trust that whoever wins will take that into account. I think that’s what’s important from our perspective.”

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