HB 7101, An Act Establishing A Commission To Study A HUSKY For All Single-Payer Universal Health Care Program
TESTIMONY OF THE CONNECTICUT HOSPITAL ASSOCIATION
SUBMITTED TO THE HUMAN SERVICES COMMITTEE
Thursday, March 6, 2025
The Connecticut Hospital Association (CHA) appreciates this opportunity to submit testimony concerning HB 7101, An Act Establishing A Commission To Study A HUSKY For All Single-Payer Universal Health Care Program. CHA opposes a single-payer healthcare plan.
Connecticut hospitals and health systems care for patients, strengthen the state’s economy, and support vulnerable communities across the state. Every day, they work to improve healthcare access, affordability, and health equity. Even as they face ongoing challenges, hospitals provide world-class care to everyone who walks through their doors, regardless of their ability to pay. Hospitals also support an exemplary workforce as the largest collective employer in the state, contribute significantly to the state’s economy, and invest in their communities addressing social drivers of health.
HB 7101 would establish a commission to conduct an economic analysis of establishing a single-payer healthcare plan open to all in the state. The program would be modeled on the HUSKY Health (Medicaid) program and be open to any state resident with the goal of (1) eliminating duplicative health insurance programs and resulting duplicative costs to the extent permissible under state and federal law; (2) consolidating oversight, payment, and risk under one public or quasi-public entity; (3) eliminating coverage limits and cost-sharing requirements; (4) incorporating prescription drug price controls; and (5) establishing budgets and payment systems for hospitals for overnight care and a uniform fee schedule for healthcare providers not providing overnight care.
CHA opposes a single-payer healthcare plan, most especially one built off of the state’s Medicaid program.
Medicaid (HUSKY) Reimbursement
Foremost, no mention is made in this bill of the woefully inadequate provider reimbursement rates in the HUSKY Health (Medicaid) program and the enormous strain this places on providers’ ability to maintain current levels of access and operations. The issue of Medicaid underpayment is widespread and must be considered for the broad range of providers whose underpayment has been documented in the recent Medicaid Reimbursement Rate Study (see Phase 1 and Phase 2) by the Department of Social Services (DSS).
Hospitals and health systems cannot sustain the robust healthcare delivery system that Connecticut residents enjoy if they cannot cover their costs. In 2023, hospitals began to show signs of financial recovery, although statewide operating margins remained negative and Connecticut hospitals still lost $76 million. Improvement in revenue continues to be outweighed by staggering increases in operating costs like drugs, supplies, and workforce costs (which grew by $1 billion in a single year).
Hospital rates under the Medicaid (HUSKY Health) program contribute a great deal to this financial strain. Hospitals are reimbursed less than 60 cents on the dollar for the services provided to Medicaid beneficiaries after accounting for the taxes they pay to fund the state share of Medicaid services. Despite the modest annual rate increases required by the settlement agreement, the hospital operating shortfall has grown sharply in recent years, reaching $1.4 billion in FY 2023, partly as a result of unprecedented inflation.
A single-payer program based on the above substantial hospital underpayment would be disastrous for patients and hospitals. Underpayment would be markedly exacerbated by the reimbursement methods proposed in this study, which appear to include site-neutral payment for all but inpatient services. Failure to address reimbursement adequacy jeopardizes the ability of hospitals and other providers to maintain current levels of access to services for patients.
Rather than studying the feasibility and advisability of implementing a single-payer healthcare system, CHA urges the committee to work to address the chronic underpayment by Medicaid for healthcare services and the commercial insurance practices and benefit designs that delay and deny care and drive up healthcare costs.
Thank you for your consideration of our position. For additional information, contact CHA Government Relations at (203) 294-7301.