Public Option Forum – high expectations, big challenges

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Legislators were warned that ideas that sound simple are rarely that easy at last week’s forum on building a public option to bring down CT’s high health insurance premiums. The forum by the Insurance and Human Services Committees brought in national experts to explore the concept. The idea is to create a non-profit, publicly-accountable insurance option to the marketplace to drive competition and, hopefully, lower premiums. Other states are considering public options but none has implemented one yet. The failure of Co-ops, including CT’s HealthyCT, was discussed but CT’s failed Charter Oak plan, that built on our Medicaid program and ended in a death spiral, was never mentioned. States that are considering a public option generally have high uninsured rates, are threatened with no exchange in some counties and/or Medicaid managed care plans – none of these concerns apply to CT. The challenge of paying providers lower Medicare or Medicaid rates to see the same patients as one of the only ways to lower premiums was discussed. Concerns about inappropriate underservice resulting from shared savings was also raised. The Comptroller said he is cautiously exploring the possibility of allowing small businesses to buy into the state employee plan, but many questions need to be answered to ensure it is feasible. As Ted Doolittle, CT’s Health Care Advocate, noted a public option is not a “silver bullet” to bring down heathcare costs. At best, market competition will only make a marginal difference. We need to address the drivers of health costs, including high prices, especially drugs and hospital care, eliminating low-value care that is undermining health, and investing in public health innovations that keep us all healthy. CT News Junkie will be exploring a public option, among other healthcare issues, at the second Public Policy Forum Thursday, February 21st at 10am in Capitol Room 310.