Health Care
10:13 am
Tue March 22, 2011

Businesses Question Health Care Reform in Connecticut

WNPR’s Small Business Project is taking an in-depth look at the health care crisis facing small employers. In the second of our two reports, WNPR’s Harriet Jones reports on what’s being done to address the problem.

Almost everything about health care reform is controversial. But one thing everyone does agree on. It’s time to act.

“The best estimates show that health care premiums for small employers were going to increase anywhere from $9 billion to up to $15 billion in the next five years, so something had to be done.”

Victoria Veltri is Connecticut’s acting Health Care Advocate. She co-chairs the SustiNet board, which aims to provide universal health coverage at the state level. The concept of SustiNet was approved by state lawmakers in 2009, but the implementation bill is under debate. The details are complex and still changing. In broad outline, SustiNet aims to pool together state employees and retirees, HUSKY participants and Medicaid beneficiaries, and then open that state-run pool to other groups, including small business, says Veltri.

“We need to help small business, because that’s the core of economy. We also need to prop up the plans that we already administer, so SustiNet was designed with an eye towards   doing all those things.”

SustiNet’s proponents say the plan could be offered as a public option on the federal health care exchanges that are coming in 2014. But that’s highly controversial in some quarters, not least among private health insurance companies who don’t want to compete with a publicly-financed plan. None of the three major insurers contacted by WNPR were willing to discuss SustiNet specifically.  James Stirling runs Stirling Benefits, a Milford-based company that administers health plans.

“That argument about unfair competition is kind of lost on the person who’s struggling to pay the bills. They’re happy to have an alternative, if it works, that could lower their costs and improve the quality of their care.”

But not everyone believes SustiNet will achieve that. The Connecticut Business and Industry Association, like many chambers of commerce around the state, offers health care plans to its members. CBIA associate counsel Eric George says SustiNet contains so many unknowns, the state could find itself on the hook for a big financial liability.

“You have no idea about who is going to come in and participate in the SustiNet program. If individuals who have higher claims, higher risk, come in and that is more than what you’ve set aside, you’ve got to get the money somewhere.”

And others simply believe SustiNet has been overtaken by events in Washington.

“Our focus is very clearly on implementing health care reform with the help of the federal government”

Jeanette DeJesus is the special adviser to Governor Dannel Malloy on federal health care reform. She says it’s time for the focus to shift to making the federal law a reality in Connecticut.

“The environment has changed tremendously. We do now have a federal law. The support of the federal government to identify mechanisms that will really help us to lower the cost, increase the quality, and we have what people would say is an economic crisis in the state of Connecticut. We don’t want to engage in obligations that we don’t know how we’re going to be able to fund in the future.”

DeJesus recognizes the immense pressures on small business from health care issues, and she says the federal exchanges, which are under construction now for implementation in 2014 will help that group, along with many others.

“There are certain mechanisms within the exchange that we’re developing now, that will allow us to remove those cost burdens, that will allow us to provide an essential level of benefits so that people can have a choice.”

One of those choices may be to stop trying to offer coverage altogether. Martha Temple is President of the New England Market for health insurer Aetna.

“The big question everyone has is, will small employers opt out? Will they just start to give money to their employees and have them go out on their own to purchase health care. One of the things that we worry about is that’s going to be an onus on the individual employee or the individual member when they go out onto an exchange to understand what they’re selecting, and that’s going to make it more difficult.”

Temple says driving down medical costs is the ultimate key to making health care more affordable for small business. There’s no blueprint yet for how a small employer will actually be able to buy health care in this new, changed marketplace, and above all there’s no pricetag. Until the architects of change can offer some certainty on lowering premiums, the business community may remain divided on reform.

For WNPR, I'm Harriet Jones

To hear the first of the two reports, click here.