Connecticut 2019 Regular Session

Connecticut House Bill HB07339 Compare Versions

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Version 2 (New)

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7		-	General Assembly Substitute Bill No. 7339
	4	+	LCO No. 5438 1 of 3
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	6	+	General Assembly Raised Bill No. 7339
8	7		January Session, 2019
	8	+	LCO No. 5438
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	11	+	Referred to Committee on HUMAN SERVICES
	12	+
	13	+
	14	+	Introduced by:
	15	+	(HS)
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14	20		AN ACT CONCERNING A PUBLIC INSURANCE OPTION.
15	21		Be it enacted by the Senate and House of Representatives in General
16	22		Assembly convened:
17	23
18	24		Section 1. (Effective from passage) (a) Within available appropriations, 1
19	25		the executive director of the Office of Health Strategy shall convene a 2
20	26		working group to make recommendations concerning the 3
21	27		establishment of a public health insurance coverage option not later 4
22		-	than January 1, 2022, that would be (1) funded by enrollee premiums, 5
23		-	and (2) open to individuals ineligible for Medicaid who earn less than 6
24		-	four hundred per cent of the federal poverty level. The working group 7
25		-	shall study how best to expand consumer choice and improve the 8
26		-	viability and affordability of the private insurance marketplace. 9
27		-	(b) In addition to the executive director of the Office of Health 10
28		-	Strategy, the working group shall include, but need not be limited to: 11
29		-	(1) Three consumer advocates, one each appointed by the speaker, 12
30		-	the majority leader and the minority leader of the House of 13
31		-	Representatives; 14
32		-	(2) Three providers, including at least one private insurance 15
33		-	provider and one Medicaid-enrolled health care provider, one each 16
34		-	appointed by the president pro tempore, the majority leader and the 17
35		-	minority leader of the Senate; 18 Substitute Bill No. 7339
	28	+	than January 1, 2021, that would be funded by enrollee premiums and 5
	29	+	open to individuals ineligible for Medicaid. In addition, the working 6
	30	+	group shall study how best to expand consumer choice and improve 7
	31	+	the viability and affordability of the private insurance marketplace. 8
	32	+	(b) The working group shall include: (1) The State Comptroller; (2) 9
	33	+	the Commissioner of Social Services, or the commissioner's designee; 10
	34	+	(3) the Insurance Commissioner, or the commissioner's designee; (4) 11
	35	+	the Healthcare Advocate, or the Healthcare Advocate's designee; (5) a 12
	36	+	representative of the Connecticut Health Insurance Exchange, 13
	37	+	appointed by the chairperson of the board; (6) representatives of health 14
	38	+	care providers, including Medicaid providers; (7) health care 15
	39	+	consumers, including Medicaid recipients; (8) health insurance plans; 16 Raised Bill No. 7339
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42		-	(3) The Commissioner of Social Services, or the commissioner's 19
43		-	designee; 20
44		-	(4) The State Comptroller, or the State Comptroller's designee; 21
45		-	(5) The Healthcare Advocate appointed pursuant to section 38a-1042 22
46		-	of the general statutes, or the Healthcare Advocate's designee; and 23
47		-	(6) Other stakeholders as deemed appropriate and appointed by the 24
48		-	executive director of the Office of Health Strategy, including, but not 25
49		-	limited to, (A) representatives of small businesses and employee 26
50		-	groups, (B) behavioral health providers, (C) representatives of groups 27
51		-	who have faced historical barriers to accessing healthcare, and (D) 28
52		-	representatives of state agencies. 29
53		-	(c) The executive director of the Office of Health Strategy shall serve 30
54		-	as chairperson of the working group, which shall provide 31
55		-	opportunities for stakeholder input prior to submitting its 32
56		-	recommendations. The working group shall: 33
57		-	(1) Evaluate how best to establish a public coverage option for 34
58		-	persons not otherwise eligible for Medicaid pursuant to the HUSKY 35
59		-	Health program, as defined in section 17b-290 of the general statutes; 36
60		-	(2) (A) Evaluate whether the coverage option should be jointly 37
61		-	administered with the Medicaid program or another existing program, 38
62		-	and (B) if the coverage option is jointly administered with the 39
63		-	Medicaid program, recommend how to ensure that the existing 40
64		-	Medicaid program will not move to a managed care model and that 41
65		-	existing enrollees will not experience reduction to their eligibility and 42
66		-	benefits as a result of the new program's implementation; 43
67		-	(3) Identify (A) the appropriate state agency or other public or 44
68		-	private entity to administer such program, and (B) consumer 45
69		-	protections that should be included in any applicable contract; 46
70		-	(4) Formulate a plan design that includes the ten essential benefits 47 Substitute Bill No. 7339
	43	+	LCO No. 5438 2 of 3
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	45	+	(9) small businesses and employee groups, appointed by the executive 17
	46	+	director of the Office of Health Strategy; and (10) representatives of 18
	47	+	other state agencies and industries as deemed appropriate by the 19
	48	+	executive director of the Office of Health Strategy. 20
	49	+	(c) The Office of Health Strategy shall provide administrative 21
	50	+	support to the working group and may seek grants to support the 22
	51	+	study. The working group shall provide opportunities for stakeholder 23
	52	+	input prior to submitting its recommendations. The working group 24
	53	+	shall: 25
	54	+	(1) Evaluate how best to establish a public coverage option for 26
	55	+	persons not otherwise eligible for Medicaid pursuant to the HUSKY 27
	56	+	Health plan, as defined in section 17b-290 of the general statutes; 28
	57	+	(2) Evaluate whether the coverage option should be jointly 29
	58	+	administered with the Medicaid program or another existing program; 30
	59	+	(3) Identify the appropriate state agency or other public or private 31
	60	+	entity to administer such program and consumer protections that 32
	61	+	should be included in any applicable contract; 33
	62	+	(4) Formulate a plan design that includes the ten essential benefits 34
	63	+	required pursuant to 42 USC 18022 and that is funded by premiums 35
	64	+	assessed on enrollees, and, if approved by the federal government, 36
	65	+	federal premium tax credits and cost-sharing subsidies; 37
	66	+	(5) Consider how to attract and maintain provider participation and 38
	67	+	set adequate provider payment rates; 39
	68	+	(6) Review, if the program is modeled on the existing Medicaid 40
	69	+	program, protections for existing Medicaid recipients; 41
	70	+	(7) Consider how to mitigate potential adverse selection or risk 42
	71	+	segmentation; 43
	72	+	(8) Evaluate whether and how to include components of the person-44
	73	+	centered medical home, value-based insurance design or similar 45 Raised Bill No. 7339
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77		-	required pursuant to 42 USC 18022 and that is funded by premiums 48
78		-	assessed on enrollees, and, if approved by the federal government, 49
79		-	federal premium tax credits and cost-sharing subsidies; 50
80		-	(5) Consider how to attract and maintain provider participation and 51
81		-	set adequate provider payment rates; 52
82		-	(6) Consider how to mitigate potential adverse selection or risk 53
83		-	segmentation; 54
84		-	(7) Evaluate whether and how to include components of the person-55
85		-	centered medical home, value-based insurance design or similar 56
86		-	models; 57
87		-	(8) Evaluate whether the state should apply for a state innovation 58
88		-	waiver under 42 USC 18052 to allow eligible persons who enroll in the 59
89		-	plan to use tax credits and cost-sharing subsidies toward their 60
90		-	premiums; and 61
91		-	(9) Advise on how to leverage, preserve or maximize federal dollars 62
92		-	available to Connecticut consumers, companies or other entities. 63
93		-	(d) The Office of Health Strategy shall provide administrative 64
94		-	support to the working group and may seek grants to support the 65
95		-	study. 66
96		-	(e) The executive director of the Office of Health Strategy may issue 67
97		-	interim reports and findings relating to the study as the executive 68
98		-	director deems appropriate to the Health Care Cabinet established 69
99		-	pursuant to section 19a-725 of the general statutes and legislative 70
100		-	committees of cognizance. 71
101		-	(f) Not later than February 15, 2021, the executive director of the 72
102		-	Office of Health Strategy shall submit a report, in accordance with the 73
103		-	provisions of section 11-4a of the general statutes, on the results of the 74
104		-	study required pursuant to this section to the joint standing 75
105		-	committees of the General Assembly having cognizance of matters 76 Substitute Bill No. 7339
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112		-	relating to appropriations and the budgets of state agencies, human 77
113		-	services and insurance. The report shall include an actuarial and 78
114		-	economic analysis of the public health insurance coverage option. 79
	79	+	models; 46
	80	+	(9) Evaluate whether the state shall apply for a state innovation 47
	81	+	waiver under 42 USC 18052 to allow eligible persons who enroll in the 48
	82	+	plan to use tax credits and cost-sharing subsidies toward their 49
	83	+	premiums; and 50
	84	+	(10) Advise on how to leverage, preserve or maximize federal 51
	85	+	dollars available to Connecticut consumers, companies or other 52
	86	+	entities. 53
	87	+	(d) The executive director of the Office of Health Strategy may issue 54
	88	+	interim reports and findings relating to the study as the executive 55
	89	+	director deems appropriate to the Health Care Cabinet and legislative 56
	90	+	committees of cognizance. 57
	91	+	(e) Not later than February 15, 2020, the executive director of the 58
	92	+	Office of Health Strategy shall submit a report, in accordance with the 59
	93	+	provisions of section 11-4a of the general statutes, on the results of the 60
	94	+	study required pursuant to this section to the joint standing 61
	95	+	committees of the General Assembly having cognizance of matters 62
	96	+	relating to appropriations and the budgets of state agencies, human 63
	97	+	services and insurance. The report shall include an actuarial and 64
	98	+	economic analysis of the public health insurance coverage option. 65
115	99		This act shall take effect as follows and shall amend the following
116	100		sections:
117	101
118	102		Section 1 from passage New section
119	103
120		-	Statement of Legislative Commissioners:
121		-	In section 1(b), the phrase "In addition to the executive director of the
122		-	Office of Health Strategy, the" was added for clarity.
123		-
124		-	HS Joint Favorable Subst.
125		-
	104	+	Statement of Purpose:
	105	+	To expand access to affordable, quality health insurance.
	106	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline,
	107	+	except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is
	108	+	not underlined.]