Summary of Bill 1349
(An Act Establishing the Connecticut Select Care Choices Program)
Individuals not offered coverage through their employers are automatically enrolled in coverage through a
purchasing pool offering multiple private health plans.
Each enrollee can enroll in comprehensive coverage at an affordable price, on a sliding scale based on
income, using pre-tax dollars.
What does it cost?
Initial micro-simulations of this proposal showed that it would cover all CT residents and total health care
spending would rise by only $30 million. Total employer health insurance payments would drop by $170
million (3%) and households would realize $640 million per year for purposes other than health care.
Employment would increase by 2000-6000 workers and the state GDP would increase by .2%.
What is the administrative structure?
Office of the Comptroller negotiates and contracts with insurance companies and health care centers to
provide health insurance policies; requires electronic health records implemented by insurers ad health
centers; provides health consumer assistance program.
Establishes a Blue Ribbon Commission to examine the effect of the CT Select Care Choices Program on the
cost of providing medical care in the state and the accessibility of medical care for residents of the state.
What are the eligibility criteria?
Under age 65
Not covered by employer-sponsored insurance (ESI)
Minimum 6 month residency and household must include at least one family member who is employed full
How will enrollment work?
Individuals apply directly or are enrolled automatically when income is reported to DOL or DRS, or when they
seek health care.
What benefits are included?
The program makes a choice of policies, affordable to most state residents, including at least 2 benchmark
policies, the actuarial value of which is determined via a survey of employer based health insurance coverage in
New England. Each benchmark policy shall offer benefits, including but not limited to:
Office visits Speech, physical and occupational therapy
Inpatient/outpatient hospital care Home health care
Mental/behavioral health including Hospice
substance abuse treatment
Generic and brand name Rx drugs Extended care
Maternity care Dental and vision
Oral contraceptives Personalized nutrition, exercise and smoking
Durable medical equipment Complete physicals for every adult and child,
including screenings (without cost-sharing)
Employer contributions are being re-calculated in order to protect small, struggling companies.
Senior citizens who would have received ESI in retirement but the companies no longer provide coverage may purchase at
full cost. Employers may purchase coverage for their retirees as well.
Excepted individuals can purchase CT Select Care Choices at cost.
Any employee who qualifies for Title XIX Medicaid and is enrolled in an employer sponsored health insurance
policy receives supplemental coverage.
Every company with more than $100,000 in quarterly payroll will contribute a certain minimum amount to
A quarterly base contribution is assigned to each company.
For employers providing health coverage, payments made for employee and dependent health coverage and
amounts paid by employees are subtracted from the firm’s quarterly base contribution.
Firms offering coverage receive a tax credit for employer and employee payment of premiums.
Offers companies efficient purchasing credits, allowing them to keep savings derived from workplace wellness
Adults pay premiums based on income, from 0 at 185% of poverty to 30% of premiums at 300% of poverty.
A personal responsibility discount is made to premiums when an individual avoids obesity and tobacco use.
Premium co-pays in Medicaid, HUSKY and SAGA programs apply as provided for in those programs.
Employers establish Section 125 plans to allow use of pre-tax dollars and employer payments to meet
consumer premium requirements.
General Fund Contributions
The state maintains its current level of expenditure in Medicaid, HUSKY and SAGA, adjusted for inflation and
state population growth.
The General Fund subsidizes low income consumer premiums.
Costs to CT employers and taxpayers are reduced by drawing down available federal matching funds for
CSCC services provided to individuals who are potentially eligible for Medicaid or HUSKY.
Individuals are automatically enrolled in Medicaid or HUSKY unless they object.
State Medicaid plan is amended to extend eligibility to adults with incomes up to 300% of poverty.
The state applies for a waiver to allow coverage of single childless adults under Medicaid, potentially up to
185% of poverty.
Federal budget neutrality requirements for a waiver are to be satisfied with the state’s unused
uncompensated care payments to hospitals and other steps, ensuring that there is no reduction in covered
services or access to care, increase in out-of-pocket or premium costs, or any reduction in enforceable,
individual guarantees of coverage or services.
No waiver may be implemented until DSS has disclosed all of the waiver’s terms and conditions and the
House and Senate have approved it.
If federal budget neutrality requirements do not permit extending Medicaid to single childless adults, then
coverage shall extend to such individuals with incomes under the highest possible percentage of poverty less
Poverty level for an individual is $9800 and for a family of four it is about $20,000.
Federal budget neutrality requirements means that the proposed expansion will not cost the federal government any new
money over and above the reimbursement formula.