The Affordable Care Act does not establish a national public option like many progressive would have hoped, but it does allow states to form their own public plans. Today’s Politico’s Pulse reports that Connecticut is aiming to do just that, and a new report from a state board to the General Assembly argues that such an option could save Connecticut taxpayers up to $355 million in 2014.
The option, called SustiNet, follows a 2009 state law which sought to use a publicly administered health plan to implement health care delivery changes designed to slow the growth of costs. Over the course of three years, the state hopes to expand the program from state-sponsored populations, state employees and retirees, to municipalities, private employers and families:
Effective on January 1, 2014, when most federal reforms become operational, SustiNet will offer comprehensive, commercial benefits to all of the state’s employers and households. This new health insurance choice will be available both inside and outside Connecticut’s new health insurance exchange, established under the ACA. SustiNet will undertake feasibility studies, develop business plans, conduct a risk assessment, and take any other steps needed to ensure that the new competitive option is viable and adds value in the marketplace. [...]
SustiNet will offer all employers and families a new, competitive health insurance option that reforms health care delivery and payment to improve value and slow premium growth. These reforms will spark broader change throughout Connecticut. Leading by example, SustiNet’s innovations will make it easier for others to follow a similar path. Our proposal harnesses the power of competition, ensuring that successful SustiNet reforms will be replicated by private insurers seeking to preserve their market share. SustiNet will also work collaboratively to implement multi-payer reforms that help the state’s providers give their patients high- value, quality care. And by enrolling a large number of consumers, SustiNet will gain the leverage it needs to reform health care delivery and payment.
Connecticut could serve as a test case for the progressive public option talking points we all heard so much about (and repeated) during the national debate. Indeed, Oregon and Vermont are already considering more progressive alternatives than what the ACA allows and if Congress passes legislation offered by Sens. Ron Wyden (D-OR) and Scott Brown (R-MA) to permit states that meet certain benchmarks to opt out of some of the requirements of the law by 2014 (rather than the current date of 2017), we could expect even more state experimentation on the horizon.