Work In Progress: Six Myths About Obamacare In Connecticut

It's affordable.

Not really. Premiums on our state's health insurance exchange, Access Health CT, are the fourth highest in the United States, higher than any other state-run exchange.

Because the law changes the way insurance rates are set, some people will see costs drop, including women, older people and people with pre-existing conditions, while others will pay much higher premiums.

While it's true that many state residents will qualify for subsidies, they still will have to pay a hefty chunk of their income.

For example, a single young man age 32 making $32,000 yearly and living in Hartford county qualifies for $66.95 in subsidies each month. This brings his most affordable monthly premium option down to $225.71, just over 8 percent of his income. But that's not all his costs: His out-of-pocket costs such as deductibles and co-pays could reach another $6,250 in a year or another 20 percent of his income.

OK, it's not affordable for everyone. But we live in an expensive region.

Yes and no. We are the sixth healthiest state in the U.S., which should lower our costs. Connecticut residents are one-third less likely to smoke than Pennsylvanians, but our premiums are 48 percent higher. We are a third less likely to be obese than Michigan residents, but our premiums are 53 percent higher.

It's true that prices are high in Connecticut. But our premiums are higher than in Massachusetts, Rhode Island, New Jersey or New York — also expensive states.

It's good for small businesses.

It is indeed good for businesses to offer health benefits. Workers are healthier, more productive and more likely to stay with the company. But coverage has to be affordable or businesses won't be competitive.

Small businesses are especially vulnerable. They are charged 18 percent more for health coverage than large companies, on average.

Few small businesses have qualified for Obamacare premium subsidies. To get a meaningful credit, businesses must have fewer than 10 full-time employees and average wages under $25,000. The tax credits only last for two years, creating a difficult decision for small business owners when the subsidies are gone.

It replaces junk policies.

Yes and no. Obamacare does include protections against sky-high deductibles and other out-of-pocket costs, but required benefits didn't change much in Connecticut with the new law. We already had good consumer protections in our state law.

The state's Charter Oak Plan had similar benefits to exchange plans and generally lower costs, but it never had more than 15,000 members at its peak.

It's doing well.

Yes and no. The state website works very well compared to other exchanges, but it still takes about an hour to complete an application.

In the first month, only 7,092 Connecticut residents bought insurance through the exchange. The newest independent analysis estimates that 216,000 state residents could benefit from exchange coverage. We have a long way to go.

And, as with the Charter Oak Plan, those who have signed up so far tend to be older and likely to have higher medical costs. If this trend doesn't change, it will push premiums even higher, creating a spiral that didn't end well for Charter Oak.

Our hands are tied in fixing it.

Not at all. There are many fixes that could keep costs down.

One common-sense option is to let the state health care exchange negotiate premiums with insurers on behalf of consumers. That is being done in Massachusetts, Rhode Island and New York, and is one big reason why their premiums are more affordable than ours.

A bill directing Connecticut's exchange to negotiate premiums passed the state Senate last year, but died in the House of Representatives.

Reform is not going to work if coverage isn't affordable. Connecticut policy-makers have tools to keep costs down. They should use them.

Ellen Andrews is executive Director of the CT Health Policy Project, an advocacy group.

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