Kevin Lembo: Time for the public option in health care

The late U.S. Supreme Court Justice Potter Stewart famously said this of obscenity: “I know it when I see it.”

It’s too late to ask Justice Stewart whether the Republican American Health Care Act meets his obscenity test, but I can tell you this: I know health care when I see it, and this isn’t it.

The American Health Care Act recently passed by the House of Representatives, and proposals now under consideration by Republican senators, are simply not health care reform — but instead an immoral and outrageous attack on millions of Americans at risk of losing access to health care, particularly those with pre-existing conditions.

All of this to provide tax breaks to billionaires.

I have spent the better part of my life — as the state’s first Healthcare Advocate and decades before that — fighting for people who have been denied access to care, beginning with my work in the early days of the AIDS pandemic when I saw people around me dying while our government treated people as disposable.

Hear me now that, having witnessed firsthand the ugly reality of life-and-death health care obstruction, I will never give up the fight for quality and affordable access to care.

For these reasons, I believe the time for a state public option is now.

I am deeply troubled by the state of the individual insurance market in Connecticut.

Connecticut’s health insurance exchange is broken. Only two carriers now remain in the exchange and both are considering withdrawal due to financial instability that is worsening due to Republican health reform plans at the federal level.

The departure of these two remaining carriers would be disastrous for more than 110,000 residents who would not only lose coverage, but have no meaningful health care options left.

A public option would avert this increasing threat.

It would ensure the availability of at least one viable option for affordable and quality health care.

There is a path for Connecticut to pursue a public option. Section 1332 of the Affordable Care Act allows states to apply for innovation waivers to develop their own insurance and delivery system innovations while still receiving the same level of total reimbursement.

Connecticut could potentially institute a public option by leveraging the purchasing power of its two existing large-scale health plans — Medicaid or the state employee plan — to create a plan with low administrative overhead.

The administrative savings would allow the plan to provide improved benefits and lower premiums.

A public option would set premium rates with the intention of covering all claims and administrative costs, with no cost to the state.

The state could demonstrate its ability to save federal costs by offering a public option — because the federal government could minimize costs on premium assistance that it currently provides. Those federal savings could be used to help protect the state from any financial risk.

The future of federal health care remains unclear — but Connecticut’s moral responsibility remains very clear.

The state must pursue every tool available to ensure that all residents have access to quality affordable health care. A public option will ensure, regardless of devastating federal action, that Connecticut residents have a viable health care choice.

This op-ed was originally published in the CT Post.