The board in charge of developing Connecticut's future health care infrastructure doesn't have a formal representative from the business community and that's a major concern for the state's private sector.
It's also one of the reasons a new group has formed in Connecticut to try to give business interests a voice in the debate over health care reform.
The Connecticut Business Group on Health started earlier this year and so far its more than 60 member companies include many of the state's largest employers — Aetna, Northeast Utilities, Mohegan Sun and Zygo.
Although federal health care reform has already been passed by Congress, there is still a lot to be determined in how the legislation is implemented here in Connecticut.
As a result, the stakes remain high for Connecticut companies, which make up 60 percent of the health care payers in the state.
"Without business getting together and having a voice, these decisions will be made without them," said Christopher R. Coté, a principal at Mercer, a benefits consulting firm, who is also the founding member of the Connecticut Business Group on Health, or CBGH.
Coté said CBGH sees itself as an employer-led advocacy group, although Mercer has helped pull the organization together and has sponsored the first events and meetings.
The goal is to leverage the combined forces of the private sector to make an impact on the quality and cost of delivery of healthcare in Connecticut, he said.
Coté said CBGH differentiates itself from other business lobbying groups like the Connecticut Business & Industry Association and chambers of commerce, because CBGH is focused on a single issue: health care.
The organization has committees working on issues ranging from healthcare delivery, to patient-centered medical homes and health information technology.
It's not clear yet if CBGH will have its own lobbyist at the state legislature next session.
The group does have a legislative committee headed by Ted Tucci, who is a partner at the law firm Robinson & Cole in Hartford. Tucci heads Robinson & Cole's Health Law Group and has extensive experience representing managed care organizations, pharmaceutical companies, and insurers, according to the firm's web site.
One option could be to partner with other business organizations in the state and share resources. "We are looking to partner with organizations so we can combine our voices," said Coté, who is also on the board of the Rhode Island Business Group on Health.
For businesses in Connecticut, the health care landscape will change dramatically when the state sets up its Small Business Health Options Program, or "Shop Exchange." The exchange, which must be implemented by 2014, will allow individuals and small employers to form a risk pool to buy insurance.
The goal is to increase their purchasing power to enable them to find more affordable coverage.
Coté said the formation of the exchange, and determining who will have access to it, will have large implications for employers.
Besides potentially creating more affordable insurance coverage, cost is another key concern, Coté said.
Companies with fewer than 50 employees will likely have access to the exchange, but the state could decide to broaden it further to other groups and individuals. "We need to make sure the exchange is going to pay for itself and not be put on the backs of businesses to pick up the tab," he said.
Meanwhile, on the state level, the Sustinet board — a group created by a 2008 law — is in the late stages of developing a plan that will recommend to state lawmakers ways to implement federal reform and develop a state health care program.
The Sustinet board of directors is made up of 11 members, but doesn't have a formal business representative.
Paul Grady, of Mercer, who is also on CBGH's board, is a member of Sustinet's board. Sustinet is co-chaired by state Comptroller Nancy Wyman and Kevin Lembo, Connecticut's healthcare advocate. Wyman is the running mate of the democratic gubernatorial candidate Dan Malloy, while Lembo is running for Wyman's soon-to-be vacated comptroller position.
Among the options Sustinet is considering is the creation of a public option that would allow employees from small businesses, non-profits and municipalities to buy into the state insurance plan.
That has raised concerns among business lobbyists, including the CBIA, because of its potential cost impact to the state, which is already facing a deficit estimated at more than $3 billion. Proponents say it will lower health care costs for small employers by increasing their purchasing power.
Gov. M. Jodi Rell has appointed Cristine Vogel as a special advisor to help implement federal reform in Connecticut. But with Rell not seeking reelection, the new governor will wield great authority in shaping the state's future health care infrastructure.
At a recent CBGH meeting in New Haven, both lieutenant governor candidates — Wyman and Republican Mark Boughton — were in attendance and took several questions from group members.
It's getting in front of key decision makers like that, where CBGH wants to extend its influence, Coté said.
"We are trying to give business a seat at the table," Coté said.