Connecticut legislators jump onboard the Public Option Express (and more!)

With useful healthcare legislation extremely unlikely to pass the U.S. Senate until at least 2021, state-based public options will be all the rage for the next couple of years...

Connecticut lawmakers are joining other states that have unveiled proposals to expand government-run health coverage, with plans to extend state health benefits to small businesses and nonprofits, and to explore a public option for individuals.

Under two measures announced Thursday, officials would open the state health plan to nonprofits and small companies – those with 50 or fewer employees – and form an advisory council to guide the development of a public option. The legislation would allow the state to create a program, dubbed “ConnectHealth,” that offers low-cost coverage to people who don’t have employer-sponsored insurance.

Comptroller Kevin Lembo’s office would partner with one or more private insurers under an umbrella contract to provide plans outside of the state’s risk pool. The plans would meet the standards outlined in the Affordable Care Act.

The public option bill is really just a very early stage thing. It's important, but I'm actually more interested in the expansion of the state health plan, which could be implemented almost immediately since it's simply the expansion of an existing program:

If adopted, small businesses could join the state health plan as early as January. Less than half of Connecticut’s small companies offer health insurance to their workers, legislators said, despite collectively employing more than 700,000 people – about half of the state’s workforce.

This sentence makes it sound like around 350,000 people who work for small businesses are either uninsured, are enrolled in ACA exchange policies or have junk plans. According to this report, only around 200,000 of Connecticut's 3.6 million residents are uninsured altogether, though, so I'm not sure how many people this would potentially actually apply to. Ironically, expanding the state health plan would likely lower the number of CT residents enrolled in ACA exchange plans since some would presumably shift over to it, but that's not necessarily a bad thing.

The public option would be created with input from the advisory council. It would require a second round of legislative approval, and wouldn’t roll out until 2021.

That'd actually be a pretty reasonable timeframe.

The council will examine the financial impact of the public option. Sen. Matthew Lesser, D-Middletown, a co-chairman of the Insurance and Real Estate Committee, estimated that the startup costs would amount to less than $1 million.

“We’re not trying to subsidize insurance,” Lesser said. “What we’re trying to do is leverage what we have right now in place, and we’re working to try to find a way to do that without impacting the general fund.”

...“The bill provides for state-financed cost-sharing subsidies to enrollees in the ConnectHealth plan who do not qualify for cost-sharing subsidies pursuant to the Affordable Care Act,” Brennan said. “The language is silent as to how such funding will be attained.”

Hmmm...hold on, I'll have to read up more on this bill, becuase that doesn't sound like a public option at all--it sounds more like state-based subsidies for those earning more than 400% FPL, along the lines of what California is hoping to do. I'm actually very much on board with doing that as well, but it's not the same thing. Also, the "cost-sharing subsidies" wording makes it sound like the ACA's CSR subsidies, but I'm pretty sure he's talking about the general concept of taxpayer-funded financial assistance.