25 March 2007

Taking A Step Toward Medicare-For-All

A plan being pushed by State Senate leaders calls for immediate action that would provide health insurance coverage to 140,000 state residents, 40% of the 350,000 individuals in the state who are uninsured.

State Senate President Donald Williams (D-Brooklyn) presented his proposal to reform the health insurance system at a crowded meeting room of the Community Health Center on Thursday, March 22nd. Speaking next to a wall-size sign “Health Care Is a Right, Not a Privilege…” at the 35-year-old community-based clinic, Williams put the price of health care in Connecticut at $22 billion. He described the system as rife with inefficiencies as it denies more than 10% of residents access and under insures many others, especially the working poor.

Williams, who has represented his eastern Connecticut district since 1993 and is serving a third term as Senate President, offered a sober assessment of the challenges reformers face in moving toward universal coverage. He observed that federal action won’t come any time soon despite current legislation in the Congress and the tilting of the U.S. House to a Democratic majority.

Through the “Healthfirst Connecticut” initiative the Senate Democrats seek to move incrementally toward a single-payer “Medicare for All” plan modeled after the federal Medicare law adopted in 1965 that has brought a measure of health security to senior citizens ever since.

Governor Rell has introduced a counter proposal that promises universal coverage but does not involve any significant state investment. The Charter Oak Plan would be fee-based and would involve private insurers selling low-cost coverage to the uninsured. Critics, including Williams, say reducing Connecticut’s uninsured will require more money and a more comprehensive approach to reforming the system. The Rell “universal” health plan would reduce the number of uninsured, but by much less than the immediate actions proposed by Senator Williams.

Introduced by State Senator Don DeFronzo (D-New Britain, Williams called for the passage of 2007 legislation that will reduce the coverage gap. The forum included personal testimony on a video brought by Williams and by audience members on the difficulties of navigating the current system and being denied treatment.

The Healthfirst initiative would use existing federal and state insurance programs to provide health insurance to 140,000 persons. The proposal would expand the Connecticut HUSKY insurance program and increase income limits for eligibility under the public Medicaid and SAGA (public assistance) programs. A key component would raise the age of coverage for dependent children from 19 to 26. This would extend coverage to young adults starting out in a first job. More than 40% of Connecticut’s uninsured are between 19 and 34 years old. The plan would increase the income limit for a family of two from $19,800 to $24,420 as a means of extending HUSKY-A coverage. A combination of raising income limits and increasing Medicaid rates for providers would create more access immediately, according to Williams who put the cost of the program at $450 million, 50% of which would be funded by federal reimbursements.

"Right now, we spend hundreds of millions of dollars on direct care for the uninsured who, under the current system, end up treated in the emergency room when the problem is the most chronic and the solution is the most expensive. That has to change," Sen. Williams said. "Making an investment to keep the population--and the workforce--healthy is good for the economy. And it is the right thing for society to do."

To attain Medicare-for-all, Williams wants the state to “convene a health care panel to examine and evaluate policy alternatives that would consider “a statewide single-payer health care system.” These long-term strategies, said the Senate President, would be the basis for a universal health care program in Connecticut.

Juan Figueroa, President of the Universal Health Care Foundation of Connecticut, has praised the plan Williams shared with his New Britain audience last week, saying “the goal to create a ‘Medicare-for-all type’ health care system in Connecticut recognizes the need for aggressive reform measure that address the many pressing and complex issues facing the beleaguered health care system.” Figueroa similarly thanked the Rell administration for joining the debate but was much less enthusiastic about the GOP's fee for service initiative.

The nonprofit foundation advocates that any new health care policy be measured against five principles established by the national Institute of Medicine. According to the Institute, universal health coverage must: include everyone; is continuous and portable; is affordable to individuals especially those with limited incomes; is affordable and sustainable to society, and; enhances health and well-being.

Figueroa, whose organization puts the number of Connecticut uninsured at more than 400,000 persons has urged Williams to “move forward with all deliberate speed” by convening the panel on new strategies and reporting findings and recommendations by May prior to adjournment of the Legislature this year.