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Supporters Concede That SustiNet Bill Largely Gutted

Rinker Buck

April 25, 2011

Nearly four months ago, when Gov. Dannel P. Malloy was inaugurated and a new legislative session began, health care advocates imagined a promising new era under the SustiNet reform proposal.

But even SustiNet's most avid supporters now concede that its goals have largely been abandoned in the much weaker version of the legislation making its way toward the floor of the General Assembly. The much-altered SustiNet bill is the product of a compromise — some would say a gutting of the original intent of the plan — worked out by Malloy's office and legislatives leaders last week.

The sweeping proposal for state health care reform had included joining Medicaid patients and state employees in the same insurance pool to cut costs, malpractice protection for doctors, and assigning every patient a "medical home" with one doctor or practice to track and properly treat illnesses before they led to expensive hospitalizations. SustiNet's reforms would be supervised by a powerful, quasi-independent board that would operate without political interference. And a goal that had eluded national health care reformers — a public option for the uninsured — would be achieved in Connecticut.

Although the legislature is still considering pooling Medicaid patients and state employees, that will not be done with the SustiNet bill, legislators familiar with the new version of the bill said. Malpractice protection for doctors practicing under SustiNet was abandoned weeks ago, causing many doctors' groups to withdraw support for the plan. The powerful SustiNet board has been relegated to "advisory" status and will work out of the lieutenant governor's office. And a public option for the uninsured has been abandoned for now.

SustiNet promoters argued when the legislation was introduced in January that the public option was especially crucial given recent events in Washington.

"Under federal health care reform, all Americans will be required to have health insurance coverage," said Ellen Andrews, executive director of the Connecticut Health Policy Project in New Haven. "This made the public option very important because it could have been the only way for the uninsured to get an affordable plan. Now they will be at the mercy of private insurance companies. We're disappointed."

Although they acknowledge that most of the goals of SustiNet will not be achieved this year, reformers will put up a brave face on Wednesday eveningwhen they rally for SustiNet at Hartford's Union Station.

The original bill became a casualty for several reasons. Health insurance companies that would have been forced to compete with SustiNet fought the bill since the beginning. Aetna CEO Mark Bertolini telegraphed the industry's approach on Feb. 11 at a breakfast meeting held by the Middlesex County Chamber of Commerce in Cromwell when he said that SustiNet was unaffordable and predicted that it wouldn't work.

And even before the legislature's nonpartisan Office Of Fiscal Analysis released its estimate that the cost of providing coverage for the poor and uninsured could be $483 million a year, Malloy was backing off the SustiNet plan, saying that balancing the state budget was his priority.

Republicans in the General Assembly, many of whom opposed SustiNet on principle, consider the watered-down bill a major victory.

"At this point, all we're doing by voting on a SustiNet bill is institutionalizing the name," said Sen. Jason Welch, R-Bristol, the ranking member of the public health committee. "Yes, we'll be pooling municipal and state employees in a single plan, but that's being done in a separate bill that was already out there, and you didn't need Sustinet for that. This has been a very public defeat for the supporters of SustiNet."

Courant staff writer Matthew Sturdevant contributed to this story.