Connecticut: Dems push back on assn. plans, in favor of moving small biz employees to ACA exchange & expansion of CoveredCT!

An interesting article via Jamil Ragland of CT News Junkie:

Six Democratic lawmakers went on the offensive today against what they believe is a better alternative to Association Health Plans.

(Note: The phasing of this lede is confusing...it makes it sound like the lawmakers oppose the better alternative, which the article makes clear is not the case.)

Association Health Plans, which are not currently allowed in Connecticut, would allow small businesses to form a group and purchase health insurance in bulk. However, that health insurance doesn’t come with the protections of the Patient and Affordable Care Act. 

It's been quite awhile since I've written about the "Ass" part of #ShortAssPlans; here's a few basics via Robert Pear of the New York Times:

But these health plans, created for small businesses, have a darker side: They have a long history of fraud and abuse that have left employers and employees with hundreds of millions of dollars in unpaid medical bills.

The problems are described in dozens of court cases and enforcement actions taken over more than a decade by federal and state officials who regulate the type of plans Mr. Trump is encouraging, known as association health plans.

In many cases, the Labor Department said, it has targeted “unscrupulous promoters who sell the promise of inexpensive health benefit insurance, but default on their obligations.” In several cases, it has found that people managing these health plans diverted premiums to their personal use.

OK, so Association Plans are bad news, which is part of the reason they're banned in Connecticut. So what do these Dems want instead?

...Democrats want to revisit a proposal last year that would allow the Insurance Department, which only regulates state plans, to be able to grill insurance companies further over their cost increases. In 2024, the average rate increase for state regulated plans was 9.4%. Another proposal would create a program to analyze the role of pharmacy benefit managers in the state. 

Both of these make sense to me. What else?

Reps. Christine Conley, D-New London, and Liz Linehan, D-Cheshire, pitched tax incentives. Under their plan, businesses would receive tax breaks and incentives for covering employees at the silver level and above through Access Health CT. They also pitched expanded credits to businesses that contribute towards employee’s health savings accounts or deductibles.

Huh. This is very interesting. The phrasing doesn't clarify whether these incentives would apply towards Access Health CT's Individual or Small Business (SHOP) policies; the ACA's SHOP program has been a dud in most states (CMS doesn't even bother reporting enrollment figures), but there's a handful where it's doing reasonably well. I'm not sure how many are enrolled in Connecticut, although as of 2021 they had 2,193 small businesses participating.

This also sounds like an opportunity for some sort of integration with ICHRA plans, although I'm not sure how that would work.

Lastly, the Democrats proposed what they are calling Covered CT 2.0, an expansion of Covered CT, a program which provides low cost health and dental insurance and non-emergency medical transportation to all CT residents 19-64 that qualify.

Currently, qualification is limited to residents who don’t exceed 175% of the federal poverty line. For a family of four, that limits maximum income to $52,500. The proposal would expand full coverage to residents up to 200% of the poverty line, and between 200-300%, residents could receive coverage for a small fee.

Again, I'm not entirely sure whether the proposal being described would involve adding a full Basic Health Plan (BHP) Program to Connecticut (like Minnesota & New York already have, and as Oregon is scheduled to implement this summer), or if it really would simply provide enhanced subsidies to more individual market Access Health CT enrollees.

Either way, it's a great idea in my view. Stay tuned...

UPDATE: Arielle Levin Becker says she believes that the Covered CT 2.0 plan would not be a BHP program, which apparently requires the state to have managed care Medicaid in place; apparently it would indeed simply be a further expansion of eligibility to all residents earning up to 200% FPL at no cost & from 200 - 300% FPL for nominal premiums. She isn't 100% certain about this and isn't revealing any inside information about the legislation, however.