The wrong way forward on health insurance

The General Assembly needs to put aside overly complicated half-measures and work toward better coverage for all, regardless of whose bottom line is affected.

The Connecticut General Assembly is working toward a laudatory goal on health care, which is to reduce the cost of insurance and thereby open care to more people. It doesn’t work to have a great health care system if people are unable to avail themselves of it. When it comes to increasing access, everyone is on the same page — rhetorically, anyway.

How to get there is another story.

The current debate is over what are known as Association Health Plans, which are a form of group medical insurance for employers that allow smaller companies and nonprofits to access the health insurance savings associated with large group coverage. It’s all about economies of scale; what wouldn’t be available to a person or small group is possible for a larger group because the numbers balance out.

That’s the theory, at least, and the plan has earned bipartisan support. Rep. Kerry Wood, a Democrat and co-chair of the Insurance and Real Estate Committee, is supporting the plan, as are Republicans such as Sen. Tony Hwang and Rep. Cara PavlockD’Amato. This would seem to be a good way forward in a legislature where large-scale reforms have been stymied by the governor and the influence of the insurance lobby.

But it’s not so simple. Testifying against the proposal for Association Health Plans this week was Sen. Matt Lesser, who was previously chair of the committee and has worked hard in recent years for more robust insurance reform. Lesser made the point, backed up by the state’s health care advocate, Ted Doolittle, that the plans in question would not contain many of the protections that customers have come to expect in insurance.

Specifically, Lesser said, Association Health Plans could conceivably discriminate against older workers or women by charging higher premiums depending on a workplace’s profile. These are the kind of fluctuations that were supposed to be eliminated under the Affordable Care Act, but that could come back into play were the bill to pass. That would have the effect of putting people back on the open market.

The bottom line is that the plans would be more affordable because they wouldn’t be as good. They wouldn’t do what we’d expect of health insurance, and it would be by design.

There is nothing simple about this issue, but it’s also not necessary to make it quite so hard. We want people to have access to health care, both for moral reasons, because it’s the right thing to do, and for economic reasons, because it’s cheaper to get people care they need regularly rather than deal with major problems that have gone untreated.

Getting people access to health care requires insurance. We could make this easy — we could guarantee coverage for anyone, or for large groups, and ensure regulations are in place to protect people in their time of need from surprise expenses or denial of service.

We don’t do this because it’s not in the best financial interest of powerful people, including in the state capital. The General Assembly needs to put aside overly complicated half-measures and work toward better coverage for all, regardless of whose bottom line is affected.