January 26, 2007
By CHRISTOPHER KEATING, Capitol Bureau Chief
Seeking to solve Connecticut's health care woes, state Senate Democrats unveiled a $450 million proposal Thursday that would provide coverage to about 40 percent of the state's uninsured.
More than half of the money - $250 million - would be used to boost Medicaid reimbursement rates to hospitals, doctors, dentists and others who provide care for the poor.
The reimbursement proposal generated spontaneous applause in a standing-room-only audience of doctors and nurses at Hartford Hospital, where Senate President Pro Tem Donald Williams and nine fellow Democratic senators introduced a plan that will compete with several others during the current legislative session at the Capitol.
"We have a system that's too complicated and too expensive - even for those who have health insurance," Williams said. "We must fix a broken system."
The Senate Democrats' plan would expand various state programs to cover about 140,000 individuals who are currently uninsured. Although various advocates said they were pleased with the first step, they said the plan does not go far enough.
"I am disappointed that we are not moving here to universal health care fast enough," said Tom Swan, executive director of the Connecticut Citizens Action Group. "Until there's some real bold proposals and some real leadership, the health care crisis will continue to spin out of control."
One of the potential problems is the projected $450 million price tag in the first year. With fast-rising medical costs, the total is expected to jump sharply in subsequent years, legislators said. Even during the first year, the amount could cause problems with the state-mandated spending cap, which was enacted in 1991 as a compromise when the state income tax was created. The cap covers the bulk of state spending with relatively few exceptions, like state aid to distressed municipalities.
Senate Majority Leader Martin Looney, a New Haven Democrat, said the spending cap has become unrealistic if state officials are being asked to keep spending in any particular year at 4 percent, for example, when Medicaid costs might be jumping by 10 percent. Looney predicted that Republicans will be howling about the spending cap, but he said the legislature must consider lifting it.
"The time has come to take another look at the spending cap, to re-base the spending cap," Looney said. "The current cap is [skewed]. We have to stop posturing about the cap."
Rell's spokesman, Richard Harris, declined to comment Thursday on the spending cap or the details of the Senate Democrats' plan. Rell has said repeatedly that she opposes changes to the cap, and she blocked attempts by Democrats last year to adjust the definition of the cap. The state has broken the cap multiple times in the past decade, but both Rell and former Gov. John G. Rowland strongly opposed changes for anything other than special exceptions.
Since Medicaid is a 50-50 program, the overall cost in the Senate plan would be split between the state and federal governments. Unlike a plan put forward by Rell, the Senate plan does not rely on private insurers to offer reduced-price policies - policies senators said would not provide adequate coverage.
Besides the increased Medicaid rates that would cost $250 million in the first year, the plan would increase spending in a variety of ways. Included would be making more people eligible for the state's existing HUSKY and SAGA insurance plans by raising income eligibility limits. The plan also includes additional outreach for HUSKY - the program for uninsured children that is currently underused because thousands of parents are not signing up their own children. Rell has called for a plan in which children would be enrolled before they leave the hospital after they are born.
The Senate proposal also would raise the age for dependent children to 26, allowing young workers with no coverage to remain on their parents' plans.
House Speaker James Amann, the leader of the 107-member House Democratic caucus, described the Senate proposal as "a very reasonable plan" that covered common ground with the House. Further details on the House plan, including reducing costs and promoting preventive care, will be unveiled Feb. 5. But Amann said he needs more details on how the state would pay for the coverage in the Senate Democrats' plan.
"That's the big $450 million question," Amann said. "It's great if we can find the $450 million the first year. [But], you might spend $500 [million] the second year and $550 [million] the next year."
Noting that the Senate Democrats did not call for universal coverage, Amann reiterated his statements that legislators likely cannot solve all health problems in one year and should focus on expanding coverage for children this year by expanding the already-existing HUSKY program.
"We have the wheel," Amann said. "We don't have to reinvent the wheel. We have to invest in the wheel."
Without providing details on how the Senate plan would be financed, Williams said he was not ruling out anything - including a tax increase.
Patrick Scully, a spokesman for the Senate Democrats, said the proposal is markedly better than Rell's plan that calls for $3,000-per-year premiums that he described as unaffordable for many families.
"Her plan isn't a plan. It's a wish," Scully said. "She's assuming HMOs will come forward and say they'll do it for $250 a month. There's no indication that that's going to happen. If an HMO is willing to do that, why wouldn't they be doing that now?
Reprinted with permission of the Hartford Courant.
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