Connecticut: States Establish Frameworks for Health Reform

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The 10-member, legislatively-created HealthFirst Connecticut Authority released a draft report in December that has identified an urgent need for expanded health coverage and transformation of the system of care. The draft report provides recommendations for ways to expand and improve health coverage, while also addressing issues that affect both the insured and uninsured, such as health information technology, wellness, and chronic diseases. The Authority focused on the complementary goals of universal coverage and access to safe, effective care for all Connecticut residents by first establishing two workgroups—the Cost, Cost Containment, and Finance Workgroup (CCCF) and the Quality, Access, and Safety Workgroup (QAS). More than fifty individuals representing a broad range of interested stakeholders made up each workgroup. The Authority first met in October 2007 and held 27 meetings between then and December 2008, during which time it reviewed research and expert testimony and also hosted nine public forums throughout the state.

While the Authority is waiting for cost estimates before making final recommendations, the basic design of their coverage expansion proposal is:
  • Expanded Medicaid/SCHIP eligibility for all residents with family incomes below 300 percent FPL, including sliding scale cost-sharing; the uninsured with access to employer-sponsored insurance would received premium assistance to purchase private coverage.
  • Access to a restructured Charter Oak program, which currently allows families to buy health insurance regardless of their health status at premiums tied to income.
  • A Connecticut Health Partnership, using the state employee health benefit plan as a base, will be available to all residents and employers in order to improve employer offer rates and employee take-up rates, and to offer coverage to those in the non-group market.
The Authority also has multiple recommendations for containing costs and improving quality. Particularly, they focus on the role of data collection and analysis, emphasizing that data should drive policy development, implementation, and evaluation. The Authority also recommended that a public entity be assigned or developed to oversee the proposed reforms and better coordinate state spending on health care[i].
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[i] Information on reform efforts is based on draft documents and conversations with reform leaders in Connecticut.