Connecticut didn’t bend the health care cost curve. It broke it

CT Examiner  – Tuesday, August 18, 2026
By Tim Anop

Connecticut families and small businesses just got a preview of their 2027 health insurance bills, and the numbers are brutal. Insurers have asked state regulators to approve average premium increases of 16.2 percent on the individual market and 17.8 percent for small groups — hikes that will hit roughly 220,000 residents, with some small-group plans facing increases as high as 23 percent.

The instinct in Hartford will be to blame the insurance companies. But insurers are responding to a cost structure that state lawmakers built, mandate by mandate, regulation by regulation, over more than a decade. If Connecticut wants to know why its health insurance is among the most expensive in the country, it should start by looking at its own statute book.

Start with mandates. Connecticut now requires fully insured health plans to cover more than 80 distinct benefits — 81, per the most recent legislative research — putting the state among the top three nationally for mandate volume. Each mandate sounds reasonable in isolation: coverage for a specific therapy, a specific screening, a specific specialist. But the cumulative effect is a plan design lawmakers dictate rather than one employers and consumers can tailor to what they can afford. The state’s business community calculated that these mandates add roughly $2,085 a year to the average premium — and that figure was tallied when Connecticut had 68 mandates, not today’s 81. The real number now is almost certainly higher.

Then add the taxes and fees. State taxes, fees, and assessments pile on another $591 or so per policy — more than $100 million statewide — and that is before counting the more than $209 million a year in premium taxes insurers pass straight through to the people paying the bill.

None of this happened by accident. Lawmakers had the chance, this year and in years past, to let small businesses band together in association health plans — pooling risk the way large employers already do — and chose not to. For four consecutive years, bipartisan coalitions of lawmakers and business groups have proposed allowing association health plans in Connecticut. Each time, the bill died, opposed by the state’s own exchange, public-sector unions, and advocacy groups more interested in protecting the current system than lowering costs for the small businesses that make up the backbone of Connecticut’s economy.

At the same time, the legislature has moved to restrict the tools insurers use to manage utilization and hold down costs. Public Act 25-94, effective this year, caps how long health plans can require step therapy — trying a lower-cost treatment before a more expensive one — at 30 days, and bans it outright for a list of serious conditions including stage IV cancer, multiple sclerosis, and schizophrenia. These reforms may have real clinical merit in individual cases, and patient protections matter. But lawmakers rarely pair them with any accounting of what they cost, or any offset elsewhere in the system. Every restriction on utilization management is a restriction on the main lever insurers have to keep premiums from rising faster than they already are.

The pattern is consistent: mandate more, tax more, restrict the market-based tools that manage cost, and then express surprise when premiums go up again. Connecticut has spent years insisting it is bending the health care cost curve down. The 2027 rate filings say otherwise.

There is a better way. Since 2009, the legislature has had a tool built for exactly this — the Health Benefit Review Program, which lets the Insurance Department run a genuine cost-benefit analysis of a proposed mandate, well beyond the boilerplate of a standard fiscal note. Lawmakers rarely bother to use it. Connecticut could also let small businesses access association health plans, as most other states do, and pair any new consumer protection with a serious look at what it will cost the people paying the premium. And it should be honest that expanding state-run coverage is no free lunch: the health plan Connecticut already operates for its municipalities has run in the red for years.

None of that is exotic policy. It’s the basic discipline of asking what a rule costs before you impose it. Connecticut’s small businesses and working families — the ones opening their 2027 renewal notices this fall — deserve at least that much.

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