OFFICE OF FISCAL ANALYSIS
Legislative Office Building, Room 5200
Hartford, CT 06106 (860) 240-0200
http://www.cga.ct.gov/ofa
sSB-10
AN ACT PROMOTING ACCESS TO AFFORDABLE PRESCRIPTION
DRUGS, HEALTH CARE COVERAGE, TRANSPARENCY IN
HEALTH CARE COSTS, HOME AND COMMUNITY -BASED
SUPPORT FOR VULNERABLE PERSONS AND RIGHTS
REGARDING GENDER IDENTITY AND EXPRESSION.
Primary Analyst: LD 5/8/23
Contributing Analyst(s): SB, RDP, ME, LG, NN, MP, BP, MR, ES,
CW
OFA Fiscal Note
State Impact:
Agency
Affected
Fund-Effect FY 24 $ FY 25 $ FY 26 $
State
Comptroller -
Fringe Benefits
GF - Potential
Savings
None None See Below
Attorney
General
GF - Revenue
Gain
None None See Below
Social Services,
Dept.
GF - Cost See Below See Below See Below
Department of
Revenue
Services
GF - Cost Up to
75,000
None None
Public Health,
Dept.
GF - Cost 30,000 None None
Judicial Dept. PCAF - Revenue
Loss
600,000 600,000 600,000
Note: GF=General Fund; PCAF=Probate Court Administration Fund
Municipal Impact:
Municipalities Effect FY 24 $ FY 25 $ FY 26 $
Various
Municipalities
Savings None None See Below
Explanation
Sections 2-4 may result in savings to the state and retiree health 2023SB-00010-R000735-FN.docx Page 2 of 3
plans, as well as fully insured municipal plans through prescription
drug price limitations established in the bill. Any savings to the plans
will be used to reduce prescription drug costs to the insureds. Savings
will begin in 2026 and accumulating in the outyears as the U.S. Health
and Human Services (HHS) secretary negotiates the maximum fair price
for prescription drugs.
Section 4 also provides the Office of the Attorney General (OAG)
with exclusive authority to enforce violations of the provisions
contained within Sections 3 and 4 of the bill, which could result in a
General Fund revenue gain beginning in FY 26 to the extent enforcement
results in fines issued. The bill requires that manufacturers or
distributors would be subject to a civil penalty of (1) $500,000, or (2) the
purchaser's amount of annual savings generated from the maximum fair
price limits in Section 3.
Section 10 mandates at least two licensed clinical social worker visits
for each individual enrolled in home and community-based services
waivers administered by the Department of Social Services. This results
in significant costs to DSS and would be based on the number of clients
receiving services, the rate paid, and the extent to which individuals are
receiving services regardless of need.
Section 11 results in a cost to the Department of Social Services
associated with designing and implementing a program to provide
Medicaid reimbursement to certified community health workers. The
extent of cost to the state depends on the Medicaid rate to be established
and the utilization of services provided by community health workers.
Section 13 results in a cost to the Department of Social Services of
$16.5 million in FY 24 and $43.3 million in FY 25 to increase the income
limit for the CoveredCT program to 200% of the Federal Poverty Level.
Section 14 results in additional program costs to the Department of
Social Services to the extent the plan to expand income eligibility up to
300% FPL is approved and implemented. 2023SB-00010-R000735-FN.docx Page 3 of 3
Section 15, which requires personal income tax forms and
instructions to be revised for certain specified purposes, results in a one-
time cost of up to $75,000 to the Department of Revenue Services in FY
24 associated with programming updates to the CTax tax administration
system and myconneCT online portal, as well as form modification.
Section 15 may also result in minimal costs to the exchange (i.e.,
Access Health CT), to its own resources as a quasi-public agency,
associated with using tax return data for targeted outreach and
marketing. The exchange already conducts marketing using its own
funds. Any additional costs resulting from the MOU would be incurred
only after a revised tax return form is in use.
Section 16, which requires the Department of Public Health (DPH)
and municipal registrars of vital statistics to issue an amended birth
certificate to reflect a parent’s legally changed name upon the receipt of
certain documents, is anticipated to result in an Information Technology
consultant cost of approximately $30,000 in FY 24 only to update DPH's
Electronic Birth Registry to allow for these names changes. There is no
fee associated with the issuance of amended birth certificates and,
therefore, no anticipated revenue gain to the state or municipalities.
Section 21 removes the $250 filing fee that the Probate Court collects
for name change petitions resulting in an estimated $600,000 annual loss
in revenue to the Probate Court Administration Fund (PCAF).
The bill also makes technical, clarifying, and procedural changes that
result in no fiscal impact.
The Out Years
The annualized ongoing fiscal impact identified above would
continue into the future: 1) subject to prescription drug prices negotiated
by the U.S. Health and Human Services (HHS) secretary; 2) based upon
the number of name change petitions; 3) to the extent to which
enforcement by OAG results in the recoupment of fines; and 4) subject
to inflationary measures.