Connecticut 2021 Regular Session

Connecticut Senate Bill SB01090 Latest Draft

Bill / Comm Sub Version Filed 04/19/2021

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