ICYMI in Reason: “After 40 Years, No One Has Produced a Workable Single-Payer Health Care Plan”

HARTFORD, Conn. – In case you missed it, in a recent op-ed published in Reason, Veronique de Rugy, a senior research fellow at the Mercatus Center at George Mason University, examines why decades of efforts to establish government-run health care systems have repeatedly failed to produce a workable model capable of delivering on promises of lower costs and expanded coverage.

The article highlights a critical point Connecticut policymakers should seriously consider. Citing Jessica Riedl, an economist with the Brookings Institution, de Rugy notes that supporters of government-run health care have yet to identify both “a provider payment system that actually saves money” and “a financing mechanism” capable of funding expanded coverage without creating new costs elsewhere in the system. As de Rugy writes, “Despite hundreds of legislative proposals and multiple presidential campaigns built around the issue, no one has met the challenge.”

De Rugy further points to several state-level examples that illustrate these challenges. In 2014, Vermont lawmakers abandoned their single-payer effort after determining the payroll and income taxes required to sustain the program would be “politically unsurvivable.” In 2016, Colorado voters rejected their single-payer initiative after the legislature stated it would raise taxes by $25 billion to fund the system. And, in 2022, a Californian legislative analyst reported that the proposed single-payer system would cost between $494 billion and $552 billion annually.

These lessons should serve as warning signs as Connecticut policymakers prepare to consider proposals that could reshape how health coverage is offered to small businesses, nonprofits and individuals across the state.

Connecticut does not need to speculate about what happens when government takes on a larger role in designing and financing health coverage. Recent research and similar programs within the state have already provided valuable lessons about the financial and operational challenges these proposals create.

A 2026 analysis by KNG Health Care Consulting found that creating a public option in Connecticut could lead to a decline in state revenue, lower reimbursement rates for providers and higher taxes. The report estimated that provider reimbursement rates could need to be reduced by 19 percent to maintain financial viability, while maintaining existing reimbursement rates could require the state to raise between $134.5 million and $17.3 billion in new revenue.

Connecticut’s own experience with government-run coverage programs has also raised concerns. Recent reporting found that the state-run Partnership Plan 2.0 paid nearly $23 million more in claims than it collected in premiums during the 2024-25 fiscal year and accumulated $31 million in losses during its first two years of operation. Those shortfalls underscore the challenges government-designed health plans can face when costs exceed projections leaving taxpayers responsible for the difference.

Additionally, the state’s own employee health plan helped push Connecticut over its FY2025 budget: “higher costs for Medicaid coverage and state employe[e] and retiree benefits account for significant portions” of the anticipated budget overruns. This is another clear demonstration that government-run health systems in Connecticut are unaffordable and unsustainable, and that expanding state-controlled coverage would only exacerbate these fiscal problems.

The failures highlighted across the country, combined with Connecticut’s own experience with the Partnership Plan and previous public option proposals, should give policymakers pause before pursuing government-directed health coverage initiatives.

Instead of repeating mistakes that have already played out in other states, policymakers should carefully consider whether proposals that expand government’s role in health coverage would ultimately create new financial risks for taxpayers, patients and providers without addressing the underlying drivers of health care costs.

Read the full Reason op-ed HERE.

Read the full KNG analysis HERE.