Governor's Bill No. 5041 seeks to enhance healthcare coverage in Connecticut through the establishment of the "Connecticut Option program," which aims to lower health insurance premiums. The bill mandates the Office of Policy and Management to conduct a feasibility study on the program, analyzing design elements such as provider reimbursement methodologies and potential premium assistance programs. An interim report is due by January 15, 2027, and a final report by January 31, 2028. Additionally, the bill introduces provisions requiring health benefit plans to include lower-cost generic drugs and biosimilars on their formularies, effective January 1, 2027, while prohibiting more restrictive formulary exception processes for these alternatives.

The bill also establishes the Covered Connecticut program within the Department of Social Services, providing premium and cost-sharing subsidies to eligible individuals with household incomes up to 175% of the federal poverty level. It modifies existing law by deleting references to the Office of Health Strategy and replacing them with the Department of Social Services. New provisions include potential coverage for dental and nonemergency medical transportation services starting January 1, 2027, and annual reporting requirements for the Commissioner of Social Services. The bill emphasizes the use of in-network healthcare providers for benefits and introduces a tax credit for small businesses that adopt individual coverage health reimbursement arrangements. Overall, the bill aims to improve healthcare affordability and accessibility for low-income residents while streamlining existing healthcare program language.

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