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A new economic modeling analysis by RAND for the Council of State Governments estimates that 170,000 more CT residents will gain coverage by 2016 under health reform bringing our uninsured rate from 11% to 5%. The report also predicts that slightly more employers will offer coverage; employers will remain the largest source of coverage for most state residents. RAND estimates that over 300,000 state residents will gain coverage through the state insurance exchange and Medicaid roles will increase by 130,000. State employee coverage enrollment is not expected to change but spending is expected to be $110 million less than it would have been without reform between 2011 and 2020. Unlike the four other states in the report, CT’s state government spending on health care is expected to drop by 10% during those years compared to what it would have been without reform. Other states studied are expected to see an increase in spending of between 3% (Montana) and 10% (Texas and Illinois). The study also underscores why Connecticut must build on the health care insurance exchanges established under federal reform with SustiNet. The insurance exchange will only cover about 40,000 of the state’s small business workers, despite the fact that they are five times more likely to be uninsured. It will be critical to have a strong, affordable, publicly accountable option like SustiNet available to ensure that every state resident and every small business has a real opportunity to benefit from national health reform. Connecticut is likely to see further savings with the implementation of other reforms, such as patient centered medical homes and payment reform, outlined and facilitated by SustiNet and not included in the RAND report. Ellen Andrews