Malloy Cautious
On SustiNet Timetable

HARTFORD — With Democratic lawmakers ready to speed toward a new public health-insurance system for Connecticut, their partner in the governor’s mansion is sounding a more cautious note.

As three legislative committees huddled Monday in a joint all-day hearing on bills to transform the proposed SustiNet health insurance program from blueprint to reality, Ben Barnes, Gov. Dannel P. Malloy’s budget director, sounded lukewarm about the need for urgent action.

“It’s a little premature to set up SustiNet with the aggressive timetable in the bill,” Barnes said in an interview.

SustiNet is a program set up by lawmakers to create a plan for health insurance reform in Connecticut. It was created by a Democratic legislature as a homegrown way to bring universal coverage to Connecticut, and, ideally, save money and improve health care in the process.

A board appointed by the legislature delivered its report last month, leaving legislators to make it law. Monday’s joint committee hearing, which played to a packed house for several hours, was the first step.

These hearings don’t include any decisions. This one lasted into the evening, with the audience — and legislative participants — dwindling as the hours ticked by.

Barnes outlined the Malloy administration’s concerns in testimony to the General Assembly’s public health, insurance and health services committees. He emphasized that the administration ​“fully supports the goals of SustiNet.”

In an interview later Monday, Barnes said the administration is worried that the proposed SustiNet legislation gives too much power to a quasi-governmental authority it would create. Some of those powers, including the ability to set rates for Medicaid recipients and negotiate with state workers, could cause problems when they intersect with federal health care reform efforts, he said. 

“We’re committed to the federal heath care reform process as the primary vehicle” for insuring as many Connecticut residents as possible, Barnes said. Beginning in 2014, the federal law would set up so-called ​“exchanges” to sell health insurance that’s subsidized by the federal government.

“I think that SustiNet has to happen in a way that reinforces and improves the outcomes within the context of a health-care exchange,” Barnes said.

Rep. Elizabeth Ritter, a Democrat who co-chairs the Public Health Committee, said that while she thinks the timetable isn’t that fast, Barnes’ comments are a good starting point for discussions with Malloy.

“I don’t blame him for perhaps taking a skeptical look at it,” she said.

Donovan Pushes For Insurance Pooling

In the Capitol complex Monday, advocates for SustiNet tried to pick up the pace of implementation. Experts, advocates and citizens testified before the joint committee, including House Speaker Christopher G. Donovan, a Meriden Democrat.

Donovan was testifying in support of SustiNet, but also on behalf of a bill he’s proposing that shares some of the same goals.

He’s again pushing legislation, which was vetoed in 2008 by former Gov. M. Jodi Rell, to allow cities and towns to buy into the state’s health insurance plan for their workers. The bill would eventually allow small businesses and nonprofit organizations to buy in, too — part of the long-term plan for SustiNet as well.

Flanked by Hartford Mayor Pedro E. Segarra, Donovan said his proposal would save the state and its smaller municipalities money.

“It’s a basic insurance idea,” Donovan said, ​“You have more people in it, you have more savings.”

That’s the strategy behind the initial SustiNet plan as well. Under the timetable laid out in the bill, cities and towns could buy in starting this July, for both their employees and retirees. Beginning as soon as January, under the auspices of a new organization created to oversee the insurance plans, patients now covered under Medicaid and HUSKY, the state’s child health-care program, would join state workers in one big insurance pool, with the same benefit levels each program has now.

As soon as possible, small businesses, nonprofit organizations, and companies that have state contracts could buy in. In 2014, that offer would be extended to individuals and businesses of all sizes — around the same time the exchanges, and the public option, might come online.

Cost savings are a key selling point of the new plan. The state spends roughly $8 billion a year on health care. Another selling point is covering those who can’t afford insurance, and encouraging better health outcomes for as many people as possible.

Comptroller Kevin Lembo, who was on the SustiNet board and spent six years as the state’s health care advocate, said he wasn’t concerned that Donovan’s bill might interfere with the larger effort to put the broader framework in place.

“I think it’s a strategic decision on the part of the sponsor of the bill to keep the concept moving forward,” Lembo said.

Lembo told lawmakers that more study is needed to figure out whether a true public option is right for Connecticut.

“You can’t flip a switch on a public option,” he said. ​“That we should create it is my view, but we should let the numbers drive our decision-making.”

Pharmacies Object To Parallel Proposal

Numbers are everywhere in this debate, whether you’re talking about spending money or saving it. One big question is whether the cash SustiNet’s proponents are banking on from the federal government will actually turn up, given the ongoing battle in Washington over the national bill.

Another is whether legislators can actually bring themselves to cut the state’s spending on health care. On Monday, more than half a dozen lawmakers pressed Donovan, Lembo and others about a parallel effort to save dollars by moving Medicaid and HUSKY patients into the same prescription drug program used by state employees and retirees. 

Legislators said they’d received calls and e‑mails from small, independent pharmacies worried that they’ll lose money, because the state currently pays a higher price for drugs for the Medicaid and HUSKY programs, as well as a higher dispensing fee. The fee will stay the same under the proposal.

Lembo called the dust-up over the pharmacies a kind of warm-up for the more vigorous battles to come.

“As a legislator pointed out, the money comes from somewhere, and when it does, there’s a constituency attached to that — and a lobbyist,” Lembo said. ​“This is not going to be a year filled with easy decisions.”