Connecticut 2021 Regular Session

Connecticut Senate Bill SB01090 Compare Versions

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Version 2 (New)

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7		-	General Assembly Substitute Bill No. 1090
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	6	+	LCO No. 4717 1 of 6
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	8	+	General Assembly Raised Bill No. 1090
8	9		January Session, 2021
	10	+	LCO No. 4717
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	13	+	Referred to Committee on HUMAN SERVICES
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	16	+	Introduced by:
	17	+	(HS)
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14	22		AN ACT ESTABLISHING A COMMISSION TO STUD Y A HUSKY FOR
15	23		ALL SINGLE PAYER, UNIVERSAL HEALTH CARE PROGRAM.
16	24		Be it enacted by the Senate and House of Representatives in General
17	25		Assembly convened:
18	26
19	27		Section 1. (Effective July 1, 2021) (a) As used in this section, "HUSKY 1
20	28		for All Single Payer, Universal Health Care Program" means a single 2
21	29		payer, universal health care program that: (1) Eliminates duplicative 3
22	30		health insurance programs and resulting duplicative costs to the extent 4
23	31		permissible under state and federal law; (2) consolidates oversight, 5
24	32		payment and risk under one public or quasi-public entity; (3) eliminates 6
25	33		coverage limits and cost sharing requirements, including, but not 7
26	34		limited to, (A) deductibles, (B) copayments, and (C) coinsurance; (4) 8
27	35		incorporates prescription drug price controls; and (5) establishes 9
28	36		budgets and payment systems for hospitals for overnight care and a 10
29	37		uniform fee schedule for health care providers not providing overnight 11
30	38		care. 12
31		-	(b) There is established a commission to study establishing a HUSKY 13
32		-	for All Single Payer, Universal Health Care Program in the state. The 14
33		-	commission shall contract with an independent person or entity for an 15
34		-	economic analysis of establishing such program. Such person or entity 16
35		-	shall have completed not less than two such economic analyses of 17
36		-	establishing a single payer, universal health care program on the state 18 Substitute Bill No. 1090
	39	+	(b) There is established a commission to study and make 13
	40	+	recommendations concerning establishing a HUSKY for All Single 14
	41	+	Payer, Universal Health Care Program in the state. The commission may 15 Raised Bill No. 1090
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43		-	or federal level. 19
44		-	(c) The commission shall be composed of: 20
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	47	+	contract with an independent person or entity for an economic analysis 16
	48	+	of establishing such program provided such person or entity has 17
	49	+	completed not less than two such economic analyses of establishing a 18
	50	+	single payer, universal health care program on the state or federal level. 19
	51	+	(c) The commission shall be comprised of: 20
45	52		(1) The executive director of the Office of Health Strategy, established 21
46	53		pursuant to section 19a-754a of the general statutes, or the executive 22
47	54		director's designee; 23
48	55		(2) The chief executive officer of the Connecticut Health Insurance 24
49	56		Exchange, established pursuant to section 38a-1081 of the general 25
50	57		statutes, or the chief executive officer's designee; 26
51	58		(3) The chairperson of the Council on Medical Assistance Program 27
52	59		Oversight, established pursuant to section 17b-28 of the general statutes, 28
53	60		or the chairperson's designee; 29
54	61		(4) The Healthcare Advocate, appointed pursuant to section 38a-1042 30
55	62		of the general statutes, or the Healthcare Advocate's designee; 31
56	63		(5) The chairpersons of the Behavioral Health Partnership Oversight 32
57	64		Council, established pursuant to section 17a-22j of the general statutes, 33
58	65		or their designees; 34
59	66		(6) The chairpersons of the joint standing committees of the General 35
60	67		Assembly having cognizance of matters relating to human services, 36
61	68		insurance, labor and public health, or their designees; 37
62		-	(7) At least four health care consumers appointed by the chairpersons 38
63		-	of the joint standing committees of the General Assembly having 39
64		-	cognizance of matters relating to human services, insurance, labor and 40
65		-	public health and at least two health care consumers appointed by the 41
66		-	ranking members of said committees, including, but not limited to, 42
67		-	persons who have (A) collected unemployment within the two-year 43
68		-	period preceding July 1, 2021, (B) been without health insurance for at 44
69		-	least three months within the two-year period preceding July 1, 2021, 45
70		-	(C) obtained insurance through the Consolidated Omnibus Budget 46
71		-	Reconciliation Act, or COBRA, due to circumstances including a 47 Substitute Bill No. 1090
	69	+	(7) The Insurance Commissioner and the Commissioner of Social 38
	70	+	Services, or their designees; 39
	71	+	(8) The chief executive officer of the Connecticut Hospital 40
	72	+	Association, or the chief executive officer's designee; 41
	73	+	(9) The president of the Connecticut State Medical Society, or the 42
	74	+	president's designee; 43 Raised Bill No. 1090
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78		-	voluntary or involuntary job loss within the two-year period preceding 48
79		-	July 1, 2021, (D) filed an individual income tax return itemizing medical 49
80		-	expenses in the five-year period preceding July 1, 2021, (E) ever been 50
81		-	ineligible to buy health insurance through the Connecticut Health 51
82		-	Insurance Exchange, or (F) been without health insurance and lack legal 52
83		-	immigration status. 53
84		-	(8) The Insurance Commissioner and the Commissioner of Social 54
85		-	Services, or their designees; 55
86		-	(9) The chief executive officer of the Connecticut Hospital 56
87		-	Association, or the chief executive officer's designee; 57
88		-	(10) The president of the Connecticut State Medical Society, or the 58
89		-	president's designee; 59
90		-	(11) Two providers of medical services under the medical assistance 60
91		-	program and two persons who receive such services under the program, 61
92		-	appointed by the chairperson of the Council on Medical Assistance 62
93		-	Program Oversight; 63
94		-	(12) One representative each from Health Equity Solutions and 64
95		-	United States of Care, appointed by the executive director of the Office 65
96		-	of Health Strategy; 66
97		-	(13) Two representatives of the private health insurance industry, 67
98		-	appointed by the executive director of the Office of Health Strategy in 68
99		-	consultation with the president of the Connecticut Association of Health 69
100		-	Plans; 70
101		-	(14) Two representatives of labor unions representing employees 71
102		-	who work in health care fields and one representative each from the 72
103		-	Service Employees International Union and United Electrical Radio and 73
104		-	Machine Workers of America, Local 222, appointed by the executive 74
105		-	director of the Office of Health Strategy; 75
106		-	(15) Two persons from academia with expertise in economics or 76 Substitute Bill No. 1090
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	80	+	(10) Two providers of medical services under the medical assistance 44
	81	+	program and two persons who receive such services under the program, 45
	82	+	appointed by the chairperson of the Council on Medical Assistance 46
	83	+	Program Oversight; 47
	84	+	(11) One representative each from Health Equity Solutions and 48
	85	+	United States of Care, appointed by the executive director of the Office 49
	86	+	of Health Strategy; 50
	87	+	(12) Two representatives of labor unions representing employees 51
	88	+	who work in health care fields, appointed by the executive director of 52
	89	+	the Office of Health Strategy; and 53
	90	+	(13) Two persons from academia with expertise in economics or 54
	91	+	health insurance, or both, appointed by the executive director of the 55
	92	+	Office of Health Strategy, provided such persons shall not be among the 56
	93	+	independent persons contracting with the commission to produce an 57
	94	+	economic analysis on establishing a HUSKY for All Single Payer, 58
	95	+	Universal Health Care Program. 59
	96	+	(d) The commission shall meet not later than thirty days after the 60
	97	+	effective date of this section. The executive director of the Office of 61
	98	+	Health Strategy, or the executive director's designee, shall serve as a 62
	99	+	chairperson of the commission and a second chairperson shall be chosen 63
	100	+	by the commission from among the members of the commission. The 64
	101	+	joint committee on legislative management shall provide administrative 65
	102	+	support to the commission. Any vacancies shall be filled by the 66
	103	+	executive director of the Office of Health Strategy or the appointing 67
	104	+	authority. If an appointing authority does not fill a vacancy within thirty 68
	105	+	days, the executive director of the Office of Health Strategy shall fill the 69
	106	+	vacancy. 70
	107	+	(e) The commission shall study: 71
	108	+	(1) Current health care spending, including, but not limited to: (A) 72
	109	+	State costs of the medical assistance program, (B) state costs of the 73
	110	+	Connecticut Health Insurance Exchange, and (C) average individual 74 Raised Bill No. 1090
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113		-	health insurance, or both, appointed by the executive director of the 77
114		-	Office of Health Strategy, provided such persons shall not be among the 78
115		-	independent persons contracting with the commission to produce an 79
116		-	economic analysis of establishing a HUSKY for All Single Payer, 80
117		-	Universal Health Care Program; 81
118		-	(16) One representative from a community health center appointed 82
119		-	by the executive director of the Office of Health Strategy; 83
120		-	(17) One representative from HealthCare Now appointed by the 84
121		-	executive director of the Office of Health Strategy; 85
122		-	(18) The executive director of the Commission on Women, Children, 86
123		-	Seniors, Equity and Opportunity, or the executive director's designee; 87
124		-	and 88
125		-	(19) Two representatives of nonprofit organizations that provide 89
126		-	direct legal representation to low-income Medicaid enrollees. 90
127		-	(d) The commission shall meet not later than thirty days after the 91
128		-	effective date of this section. The executive director of the Office of 92
129		-	Health Strategy, or the executive director's designee, shall serve as a 93
130		-	chairperson of the commission and a second chairperson shall be chosen 94
131		-	by the commission from among the members of the commission. The 95
132		-	joint committee on legislative management shall provide administrative 96
133		-	support to the commission. Any vacancies shall be filled by the 97
134		-	appointing authority. If another appointing authority does not fill a 98
135		-	vacancy within thirty days, the executive director of the Office of Health 99
136		-	Strategy shall fill the vacancy. 100
137		-	(e) The commission shall study: 101
138		-	(1) Current health care spending, including, but not limited to: (A) 102
139		-	State costs for the medical assistance program, (B) state costs for the 103
140		-	Connecticut Health Insurance Exchange, (C) average individual 104
141		-	consumer monthly health care costs for (i) participation in medical 105
142		-	assistance programs requiring cost sharing by a participant, (ii) 106 Substitute Bill No. 1090
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	116	+	consumer monthly health care costs for (i) participation in medical 75
	117	+	assistance programs requiring cost sharing by a participant, (ii) 76
	118	+	premiums for participants in the Connecticut Health Insurance 77
	119	+	Exchange, (iii) premiums for private health insurance plans, and (iv) 78
	120	+	premiums for Medicare supplement plans, Medicare health 79
	121	+	maintenance organization plans and Medicare drug plans. 80
	122	+	(2) Sources of current health care financing, including, but not limited 81
	123	+	to: (A) Federal cost sharing for the medical assistance program, (B) 82
	124	+	employer and employee costs for private health insurance, (C) federal 83
	125	+	cost sharing for the Medicare program, and (D) participant cost sharing 84
	126	+	under the medical assistance program or the Medicare program. 85
	127	+	(3) A financing methodology for a HUSKY for All Single Payer, 86
	128	+	Universal Health Care Program, including, but not limited to, whether 87
	129	+	such program should be financed, in part, through taxation on 88
	130	+	employers and employees. 89
	131	+	(4) An economic analysis of establishing a HUSKY for All Single 90
	132	+	Payer, Universal Health Care Program, including, but not limited to, a 91
	133	+	comparison of: (A) State costs for the medical assistance program and 92
	134	+	oversight by the Insurance Department of private health care insurance 93
	135	+	and state costs under a HUSKY for All Single Payer, Universal Health 94
	136	+	Care Program, (B) consumer costs for private health care insurance and 95
	137	+	consumer costs under a HUSKY for All Single Payer, Universal Health 96
	138	+	Care Program, including any costs if the program is covered in part by 97
	139	+	taxation of a consumer, (C) employer costs for private health care 98
	140	+	insurance and employer costs if a HUSKY for All Single Payer, 99
	141	+	Universal Health Care Program is covered in part by taxation of an 100
	142	+	employer, and (D) participant cost sharing for medical assistance 101
	143	+	programs or Medicare and costs for such consumers under a HUSKY 102
	144	+	for All Single Payer, Universal Health Care Program. 103
	145	+	(5) Provider payment rates under the medical assistance program, 104
	146	+	Medicare program and the private health insurance market and 105
	147	+	recommendations for provider payment rates under a HUSKY for All 106 Raised Bill No. 1090
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149		-	premiums and out-of-pocket costs for participants in the Connecticut 107
150		-	Health Insurance Exchange, (iii) premiums and out-of-pocket costs for 108
151		-	private health insurance plans, and (iv) premiums and out-of-pocket 109
152		-	costs for Medicare supplement plans, Medicare health maintenance 110
153		-	organization plans and Medicare drug plans, (D) the costs for 111
154		-	municipalities for both employees and retirees, and (E) the costs for 112
155		-	small businesses and independent contractors. 113
156		-	(2) Sources of current health care financing, including, but not limited 114
157		-	to: (A) Federal cost sharing for the medical assistance program, (B) 115
158		-	employer and employee costs for private health insurance, (C) federal 116
159		-	cost sharing for the Medicare program, and (D) participant cost sharing 117
160		-	under the medical assistance program or the Medicare program. 118
161		-	(3) A financing methodology for a HUSKY for All Single Payer, 119
162		-	Universal Health Care Program, including, but not limited to, whether 120
163		-	such program should be financed, in part, through taxation on 121
164		-	employers and employees. 122
165		-	(4) An economic analysis of establishing a HUSKY for All Single 123
166		-	Payer, Universal Health Care Program, including, but not limited to, a 124
167		-	comparison of: (A) State costs for the medical assistance program and 125
168		-	oversight by the Insurance Department of private health care insurance 126
169		-	and state costs under a HUSKY for All Single Payer, Universal Health 127
170		-	Care Program, (B) consumer costs for private health care insurance and 128
171		-	consumer costs under a HUSKY for All Single Payer, Universal Health 129
172		-	Care Program, including any costs if the program is covered in part by 130
173		-	taxation of a consumer, (C) employer and employee costs for private 131
174		-	health care insurance and employer and employee costs if a HUSKY for 132
175		-	All Single Payer, Universal Health Care Program is covered in part by 133
176		-	taxation of an employer and an employee, and (D) participant cost 134
177		-	sharing for medical assistance programs or Medicare and costs for such 135
178		-	consumers under a HUSKY for All Single Payer, Universal Health Care 136
179		-	Program. 137
180		-	(5) Provider payment rates under the medical assistance program, 138 Substitute Bill No. 1090
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187		-	Medicare program and the private health insurance market and 139
188		-	recommendations for provider payment rates under a HUSKY for All 140
189		-	Single Payer, Universal Health Care Program. 141
190		-	(6) The number of residents who are without health insurance or who 142
191		-	are underinsured under the current health care coverage programs and 143
192		-	the number of persons estimated to be without health insurance or 144
193		-	underinsured under a HUSKY for All Single Payer, Universal Health 145
194		-	Care Program. 146
195		-	(7) What entity, or entities, should oversee a HUSKY for All Single 147
196		-	Payer, Universal Health Care Program. 148
197		-	(8) A timeline for adoption of a HUSKY for All Single Payer, 149
198		-	Universal Health Care Program, including, but not limited to, (A) 150
199		-	implementing any financing methodology to fund such program, (B) 151
200		-	eliminating the oversight of any agencies or offices currently overseeing 152
201		-	health care coverage, and (C) creation of new oversight entities. 153
202		-	(9) The impact of a single payer, universal health care system on the 154
203		-	labor market, including, but not limited to, (A) the ability of employees 155
204		-	to move from job to job without the consideration of employer-156
205		-	sponsored health care benefits, and (B) the impact on current employees 157
206		-	of the private, for-profit health insurance industry transitioning to new 158
207		-	employment under a HUSKY for All Single Payer, Universal Health 159
208		-	Care Program. 160
209		-	(10) The impact of a HUSKY for All Single Payer, Universal Health 161
210		-	Care Program on achieving racial equity in access to quality, affordable 162
211		-	health care, including, but not limited to, analyses of the program's 163
212		-	potential impact on (A) disparities in insurance coverage by race and 164
213		-	ethnicity, and (B) barriers for people of color to (i) health insurance 165
214		-	enrollment, and (ii) utilization of health insurance. 166
215		-	(11) The impact of a HUSKY for All Single Payer, Universal Health 167
216		-	Care Program on existing Medicaid enrollees. 168 Substitute Bill No. 1090
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223		-	(12) Best practices from efforts in other states and jurisdictions to 169
224		-	promote health care affordability and universal health insurance 170
225		-	coverage. 171
226		-	(f) Not later than January 1, 2022, the commission shall report, in 172
227		-	accordance with the provisions of section 11-4a of the general statutes, 173
228		-	on the results of its study to the Office of Health Strategy and the joint 174
229		-	standing committees of the General Assembly having cognizance of 175
230		-	matters relating to human services, insurance, labor, public health and 176
231		-	finance, revenue and bonding. The commission shall dissolve on the 177
232		-	date such report is submitted, or on January 1, 2022, whichever is later178
	153	+	Single Payer, Universal Health Care Program. 107
	154	+	(6) The number of residents uninsured or underinsured under the 108
	155	+	current health care coverage programs and the number of persons 109
	156	+	estimated to be uninsured or underinsured under a HUSKY for All 110
	157	+	Single Payer, Universal Health Care Program. 111
	158	+	(7) What entity, or entities, should oversee a HUSKY for All Single 112
	159	+	Payer, Universal Health Care Program. 113
	160	+	(8) A timeline for adoption of a HUSKY for All Single Payer, 114
	161	+	Universal Health Care Program, including, but not limited to, (A) 115
	162	+	implementing any financing methodology to fund such program, (B) 116
	163	+	eliminating the oversight of any agencies or offices currently overseeing 117
	164	+	health care coverage, and (C) creation of new oversight entities. 118
	165	+	(9) The impact on the labor market of a single payer, universal health 119
	166	+	care system that eliminates private insurance. 120
	167	+	(f) Not later than January 1, 2022, the commission shall report, in 121
	168	+	accordance with the provisions of section 11-4a of the general statutes, 122
	169	+	on the results of its study and recommendations to the Office of Health 123
	170	+	Strategy and the joint standing committees of the General Assembly 124
	171	+	having cognizance of matters relating to human services, insurance, 125
	172	+	labor, public health and finance, revenue and bonding. The commission 126
	173	+	shall dissolve on the date such report is submitted, or on January 1, 2022, 127
	174	+	whichever is later. 128
233	175		This act shall take effect as follows and shall amend the following
234	176		sections:
235	177
236	178		Section 1 July 1, 2021 New section
237	179
238		-	Statement of Legislative Commissioners:
239		-	In Section 1(b), " such program provided such person or entity has" was
240		-	changed to "such program. Such person or entity shall have" for clarity,
241		-	and in Section 1(d), the last two sentences were redrafted for clarity and
242		-	to eliminate redundancy.
	180	+	Statement of Purpose:
	181	+	To establish a commission to conduct an economic analysis of
	182	+	establishing a single payer, universal health care program.
	183	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	184	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	185	+	underlined.] Raised Bill No. 1090
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244		-	HS Joint Favorable Subst.
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	188	+
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