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State public option would boost prospects of small businesses

If, as we move past the pandemic, Connecticut can make an affordable public option for health insurance available to small businesses, it would encourage entrepreneurs to get back in the game and more high-tech startups to give it a go in this state.

Providing employees with quality, affordable health insurance is among the biggest challenges that small businesses face. Confronting that challenge, many opt not to provide it, which can make it difficult to retain employees and leaves  workers vulnerable to accidents or health issues that can turn into financial catastrophes.

Among the lessons of the pandemic is that we want people to seek care to get well, not report to work sick.

Young professionals who may be ready to go out on their own, who have new ideas, can be discouraged from doing so, opting to play it safe in jobs where they have health insurance, even if it means delaying their dreams and limiting their opportunities.

And that is bad for the economy.

Once again a bill has been introduced in the state legislature that would give businesses with 50 or fewer employees the choice to purchase health coverage by way of a public option. The health insurance coverage available would be built off the structure of the state employee health plan. The health plan for state workers is the largest in Connecticut with buying-power force.

Comptroller Kevin Lembo, who for several years now has pushed for Connecticut to be a leader in providing better health insurance coverage, has been able to leverage the size of the state plan to negotiate advantageous agreements to achieve stable prices, prescription drugs discounts, and encourage models that prioritize preventive care.

While a business of 40 people may not have much leverage to obtain quality, affordable care, being part of a much larger buying-power group changes the equation.

Under the current proposal, nonprofits could also buy into the public option. Many of these nonprofits are agents of the state, providing a broad range of social services. But their compensation from the state has not kept up with inflationary costs, sometimes leaving them unable to supply health insurance for their employees who are providing care to others!

In testimony to the legislature, Lembo, who has had a strong record of objectively assessing state finances and who has increased fiscal accountability and transparency, has been insistent that plans offered under a public option would be self-sustaining and affordable, with no recurring cost to taxpayers.

While some have pointed to a public option as competitive with private insurers, which it will be to the benefit of consumers, the reality is that these private insurers will be signing contracts to implement and manage the various coverages offered  under a public option.

Other proposals before the legislature seek to boost affordability, through state initiatives, for individual policies. These proposals are more complex and potentially costly to taxpayers and the insurance industry, as noble as they may be. Better to begin with the public option for small businesses and nonprofits and build off that success.

Finally, any public option approved by the new Democratic majorities in Congress as an extension of the Affordable Care Act is likely to give states wide leeway in implementing it and added resources to do so. Connecticut would get a leg up by supplying a public option now.

A major plank in the platform of the state Democratic Party in the November election was providing health insurance reforms to make coverage more affordable. Voters responded by giving the party large legislative majorities. If a sound public-option bill is placed on the desk of Gov. Ned Lamont, my expectation is he would sign it — and his doing so would prove popular.

Paul Choiniere is the editorial page editor.

 

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