State + Federal Health Care Reform = A Win for Connecticut’s Economy & Health

Re-posted from healthcare4every1.org.

SustiNet, Connecticut’s 2009 law and the new federal health care reform add up to peace of mind for families and businesses by providing health care that:

• Offers quality health care choices for us all
• Gives us more for our money
• Keeps us healthy and takes care of us when we’re sick

SustiNet (CT Public Act 09-148) positions our state to be a national leader in health care reform by taking a bold, comprehensive approach to controlling health care costs, improving quality and increasing access.

Combined with the new federal health care reform laws, Patient Protection Affordable Care Act (HR 3590) and Reconciliation Act of 2010 (HR 4872), SustiNet puts Connecticut in the front of the line to leverage more federal resources to boost the state’s economy and help us achieve quality, affordable health care we can count on.

Offers a Smart Choice That Works for Everyone

Starting in 2012, SustiNet would be open to people without insurance and to small businesses to join voluntarily. This will offer people left behind by the private health insurance market an opportunity to access a quality, affordable choice before the uninsured are required to buy insurance in the insurance market exchanges mandated by federal law beginning in 2014.

SustiNet will offer a comprehensive, affordable benefit package – the same health insurance benefits as a typical large employer in Connecticut. The plan will not cut corners on care or include expensive co-pays and deductibles.

Leverages Bargaining Power to Control Costs

SustiNet ensures that the state wisely uses the dollars it is already spending on state employees, HUSKY and Medicaid by uniting them into a large self-insured health plan.

This will create a critical mass of SustiNet-insured residents giving the state leverage to control costs and improve how health care is delivered in our state.

SustiNet’s bargaining power will expand as it is opened up to residents and businesses of Connecticut. Beginning in 2012, the state will offer a new SustiNet health plan choice – as an alternative to private insurance being sold in the market – to:

• the uninsured
• sole proprietors and other self-employed people
• small businesses, municipalities, and non-profit employers

By 2014, it would be available as a choice for the uninsured, regardless of pre-existing conditions.

Improves Health and Saves Money Over Time

SustiNet does more than offer access to health insurance. It invests in improving the care and health of Connecticut's residents while controlling costs. Key features of SustiNet’s health care delivery reforms include:

• a health care provider working with every enrollee to coordinate their overall care – called a “medical home” – to enhance the quality and effectiveness of care, focus on preventing illness and enable better management of chronic health problems
• improved public health programs and prevention programs to fight obesity and tobacco use
• implementation of 21st-Century health care, including electronic medical records to promote coordination of care and avoid duplication of tests or unnecessary procedures

The goal is also to break down barriers to care by increasing provider reimbursement rates for Medicaid saving money and improving health over time.

Creates Effective Oversight and Public Accountability

SustiNet is envisioned to be rolled out over 4 – 6 years. 2010 is a crucial year for the initial design and implementation of SustiNet.

The 11-member SustiNet Board has oversight over the implementation of SustiNet with the support of five committees and three task forces. This work is being done by a diverse group of more than 150 Connecticut experts volunteering their time and skills to help SustiNet be the best health care plan for our state. Key 2010 tasks include:

• an expert analysis of the impact and opportunities for Connecticut as a result of the passage of federal health care reform (due in early June 2010)
• reports from the committees and task forces (due July 1, 2010)
• a final report to the state legislature on SustiNet’s implementation – including cost and revenue projections (due January 1, 2011)

Based upon the SustiNet Board’s final report, state lawmakers will have to pass legislation in 2011 to allow for SustiNet’s implementation in 2012.

A Boost to the State’s Bottom Line

Combined with the March 2010 passage of federal health care reform, SustiNet:

• gives Connecticut a real competitive edge over other states to take advantage of new federal grants, pilot programs and initiatives that recognize state-based health innovations
• maximizes federal resources to cover state health care costs – offering relief to families, businesses and the state budget

More Opportunity for SustiNet

The SustiNet Board’s expert analysis of the impact of federal reform on Connecticut due in June, will offer the state a real opportunity to identify:

• specific federal resources for support of SustiNet’s health care delivery reforms and ways to leverage federal health care dollars to cover more people
• beneficial adjustments to SustiNet to create more synergy between state and federal health reform

Immediate Benefits for Families and Small Businesses

Starting in 2010, the new federal law provides relief for people, including:

• qualifies 81,600 Connecticut small businesses for health care tax credits
• covers children denied coverage due to pre-existing conditions
• requires all insurers to cover annual exams and preventative treatments
• lowers prescription drug costs for seniors by closing the “donut hole”
• permits children up to age 26 to stay on their parents’ insurance policy

More Choices for Residents

Full implementation of federal reform will occur in 2014, with the creation of insurance exchanges. The exchanges will function as consumer-friendly marketplaces through which individuals and businesses may purchase health insurance. Health coverage will be mandatory for all individuals in 2014 under federal law. Connecticut’s new SustiNet health plan will be available voluntarily beginning in 2012, providing a quality, affordable choice for people.

See also: Web Resources on State and Federal Health Care Reform