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General Assembly Raised Bill No. 7339
January Session, 2019
LCO No. 5438
Referred to Committee on HUMAN SERVICES
Introduced by:
(HS)
AN ACT CONCERNING A PUBLIC INSURANCE OPTION.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (Effective from passage) (a) Within available appropriations, 1
the executive director of the Office of Health Strategy shall convene a 2
working group to make recommendations concerning the 3
establishment of a public health insurance coverage option not later 4
than January 1, 2021, that would be funded by enrollee premiums and 5
open to individuals ineligible for Medicaid. In addition, the working 6
group shall study how best to expand consumer choice and improve 7
the viability and affordability of the private insurance marketplace. 8
(b) The working group shall include: (1) The State Comptroller; (2) 9
the Commissioner of Social Services, or the commissioner's designee; 10
(3) the Insurance Commissioner, or the commissioner's designee; (4) 11
the Healthcare Advocate, or the Healthcare Advocate's designee; (5) a 12
representative of the Connecticut Health Insurance Exchange, 13
appointed by the chairperson of the board; (6) representatives of health 14
care providers, including Medicaid providers; (7) health care 15
consumers, including Medicaid recipients; (8) health insurance plans; 16 Raised Bill No. 7339
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(9) small businesses and employee groups, appointed by the executive 17
director of the Office of Health Strategy; and (10) representatives of 18
other state agencies and industries as deemed appropriate by the 19
executive director of the Office of Health Strategy. 20
(c) The Office of Health Strategy shall provide administrative 21
support to the working group and may seek grants to support the 22
study. The working group shall provide opportunities for stakeholder 23
input prior to submitting its recommendations. The working group 24
shall: 25
(1) Evaluate how best to establish a public coverage option for 26
persons not otherwise eligible for Medicaid pursuant to the HUSKY 27
Health plan, as defined in section 17b-290 of the general statutes; 28
(2) Evaluate whether the coverage option should be jointly 29
administered with the Medicaid program or another existing program; 30
(3) Identify the appropriate state agency or other public or private 31
entity to administer such program and consumer protections that 32
should be included in any applicable contract; 33
(4) Formulate a plan design that includes the ten essential benefits 34
required pursuant to 42 USC 18022 and that is funded by premiums 35
assessed on enrollees, and, if approved by the federal government, 36
federal premium tax credits and cost-sharing subsidies; 37
(5) Consider how to attract and maintain provider participation and 38
set adequate provider payment rates; 39
(6) Review, if the program is modeled on the existing Medicaid 40
program, protections for existing Medicaid recipients; 41
(7) Consider how to mitigate potential adverse selection or risk 42
segmentation; 43
(8) Evaluate whether and how to include components of the person-44
centered medical home, value-based insurance design or similar 45 Raised Bill No. 7339
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models; 46
(9) Evaluate whether the state shall apply for a state innovation 47
waiver under 42 USC 18052 to allow eligible persons who enroll in the 48
plan to use tax credits and cost-sharing subsidies toward their 49
premiums; and 50
(10) Advise on how to leverage, preserve or maximize federal 51
dollars available to Connecticut consumers, companies or other 52
entities. 53
(d) The executive director of the Office of Health Strategy may issue 54
interim reports and findings relating to the study as the executive 55
director deems appropriate to the Health Care Cabinet and legislative 56
committees of cognizance. 57
(e) Not later than February 15, 2020, the executive director of the 58
Office of Health Strategy shall submit a report, in accordance with the 59
provisions of section 11-4a of the general statutes, on the results of the 60
study required pursuant to this section to the joint standing 61
committees of the General Assembly having cognizance of matters 62
relating to appropriations and the budgets of state agencies, human 63
services and insurance. The report shall include an actuarial and 64
economic analysis of the public health insurance coverage option. 65
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage New section
Statement of Purpose:
To expand access to affordable, quality health insurance.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline,
except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is
not underlined.]