HARTFORD, Conn. — In the past decade, most states have turned Medicaid over to private plans with hopes they could control costs and improve care. Nearly half of the 60 million people in the government program for the poor are now in the managed care plans run by insurance giants such as UnitedHealthcare and Aetna.
But Connecticut, the “insurance capital of the world,” is bucking the trend. On Jan. 1, Connecticut will jettison its private health plans from Medicaid, the state-federal health insurance program. Instead of paying the companies a set monthly fee to cover the health costs of more than 400,000 children and parents, the state will assume financial responsibility.
State officials say the firms, including Hartford-based Aetna, did not fulfill their promise of lower costs and better care. “Connecticut has a 15-year history with managed care organizations and there has been a diminishing confidence in the value of what they are providing,” said Mark Schaefer, the state’s Medicaid director. “Their measured performance is not impressive.”
Sounds reasonable. They gave it 15 years, privatization didn’t save money or improve care, so they’re going back to a version of the public plan.
But how did they manage to get this through in Connecticut? How did they cut off 800 million a year in contracts to private companies, after 15 years?
Maybe this had something to do with it:
While officials in other states struggled to balance their budgets in 2011, Governor Daniel Malloy and the Connecticut General Assembly closed a deficit of historic proportions one month early, agreeing on a mix of tax hikes and union concessions. That topped a list of unmatched legislative accomplishments: Connecticut passed in-state tuition for illegal immigrants, a transgender-rights bill, a major genetic research initiative, a bipartisan job-growth package, and the nation’s first paid sick-leave mandate.
In a year of reactionary politics and partisan gridlock nationwide, what made Connecticut so different? One-party control over both the governor’s office and the legislature for the first time in 21 years played a role. But the secret behind the Democrats’ success was sweeping campaign-finance reform enacted six years earlier. Reeling from the embarrassment of a corruption scandal that landed a governor in federal prison, Connecticut legislators grabbed the national spotlight in 2005 by stopping the flow of millions of special-interest dollars, banning lobbyist contributions, and instituting a public-financing system that record-setting numbers of candidates have embraced.
Denise W. Merrill, a longtime legislator who’s now secretary of the state, saw a dramatic change among lawmakers. Suddenly, she says, “these guys didn’t even know they were supposed to check with the lobbyists.”
As the lobbyists’ clout diminished, grassroots mobilizing began to pay off. “Campaign-finance reform improved the situation for organizations that know how to research the issues and excel at grassroots organizing,” says Jon Green, director of the Working Families Party. “That kind of constituent contact has started to outweigh the pressure of lobbyists. You still have to go out there and do the work, but public opinion is starting to matter more.”
Candidates seeking public dollars would first have to raise a minimum level of funds, all in small amounts, from individual donors. A state senate candidate, for example, could receive $85,000 in state funds for the general election after first raising $15,000 from private donors—none of whom could contribute more than $100.
The level of state funding is where Connecticut has distinguished itself from other states that offer public financing. Its grants for legislative candidates are up to six times larger than those provided by Maine and nearly 20 times greater than those offered by Arizona. Unlike those states, whose initial attempts at public financing drew between 25 percent and 35 percent participation rates by legislative candidates, nearly 75 percent of the candidates participated in Connecticut in both 2008 and 2010.
“The state has made enormous progress, transforming from ‘Corrupticut,’ an example of rampant wrongdoing after years of scandal, into a model for campaign financing and the future of democracy,” says Beth Rotman, who directed Connecticut’s Clean Election Program from its inception through January 2011.
The American Prospect article is absolutely glowing and sounds almost too good to be true, but, boy, if it’s at all accurate, I want this in my state.
Too, I’m wondering if people who live in Connecticut notice any difference in the duration or tone of campaigns now that 75% of state candidates rely on public funding. Are campaigns shorter under the new rules? Fewer ads blanketing tv and radio? Less stupid, dishonest and destructive?