Connecticut Democrat Presses ‘Mandate-Lite’ Insurance Proposal

Published August 1, 2006

As Connecticut’s 2006 legislative session drew to a close in May, a measure to allow the Nutmeg State’s residents to purchase more affordable health insurance fell due to inaction.

The bill, part of what is known as the “Nutmeg Plan,” would have allowed the sale in Connecticut of insurance policies that do not include some state-mandated benefits that push up the price of health insurance and make it unaffordable for many residents.

Despite the inaction on the bill, the measure’s chief sponsor, state Sen. Joseph Crisco (D-Woodbridge), said he thought the bill would be reintroduced and passed in the 2007 legislative session.

“We are heading in the right direction” on health care reform in Connecticut, Crisco said. “The legislative leadership has made this issue a priority for the next session, and I feel confident that the Nutmeg Plan will be part of the solution.”

Coverage Menu

Crisco said the purpose of the Nutmeg Plan was to address the issue of the uninsured in Connecticut while “avoiding programs based on significant government subsidies, such as those in Maine and Massachusetts.” Other aspects of the Nutmeg Plan included performing a cost/benefit analysis of mandated services and providers, and requiring insurers to allow young adults up to age 26 to remain on their parents’ health insurance policy even if they are not in college.

Health insurance mandates require that policies include coverage for certain services or providers regardless of whether the individuals purchasing insurance want those benefits. Common mandates include requirements that chiropractic care, mammograms, and alcohol treatment be covered. Less-common mandates include coverage for wigs for patients who lose their hair during cancer treatment, acupuncture, and in vitro fertilization.

“The plan, to start, would offer the basic package plus optional benefits to a defined population–people who do not as yet qualify for their employer’s health plan, and part-time workers,” Crisco explained. Insurers would still have to offer coverage for mandated services and providers, but the insured would not have to accept coverage. For those who declined coverage for otherwise-mandated services and providers, insurance premiums would be more affordable.

“It’s like a menu,” Crisco said, “You can get the coverage you want, but skip what you don’t need.”

Heavy Mandate Burden

Crisco’s bill would have allowed part-time, seasonal, and other workers who don’t have employer-provided health insurance to buy plans that don’t include approximately half of Connecticut’s 50 mandated benefits. According to a March 2006 study by the Council for Affordable Health Insurance (CAHI), only three states have more mandated benefits than Connecticut: Minnesota (62), Maryland (59), and Texas (51).

The CAHI study, Health Insurance Mandates in the States 2006, estimates health insurance mandates increase premiums by between 20 and 50 percent, depending on the number of mandates and which ones are imposed.

Connecticut has several costly mandates, according to the CAHI study. Mental health parity–a 10-year-old federal law that prevents health plans from placing annual or lifetime dollar limits on mental health benefits that are lower than the annual or lifetime dollar limits for medical and surgical benefits offered under the plan, according to the Centers for Medicare and Medicaid Services–is the most expensive mandate in Connecticut, adding between 5 and 10 percent to premiums. Other costly mandates in Connecticut are in vitro fertilization (3-5 percent), dental care (3-5 percent), alcoholism rehabilitation (1-3 percent), social work (1-3 percent), and contraception (1-3 percent).

Business Community Support

Crisco’s plan drew praise from the Connecticut Business & Industry Association (CBIA), which spoke in its favor during hearings on March 7.

“These reforms will not fix the health care system overnight,” Eric George, associate council for CBIA, acknowledged in his remarks to the committee, but he noted the bill would “go a long way towards addressing … the ever-skyrocketing cost of health care.”

George, however, spoke against the sections of the bill that would expand the dependent coverage mandate to children up to age 26, noting such a requirement would “increase health care costs and [is] contrary to the underlying purpose of the bill.” In his testimony, he suggested this part of the bill be removed.

Sean Parnell ([email protected]) is vice president of external affairs at The Heartland Institute.

For more information … The Council for Affordable Health Insurance’s mandates report, Health Insurance Mandates in the States 2006, is available online at

Information about the federal Mental Health Parity Act is available online at