Healthcare reform in Connecticut could depend a great deal on whether state union leaders have finally allayed rank-and-file fears about insurance changes contained in a $1.6 billion union concessions deal.

The givebacks were voted down in June in part because of rumors they were a sneaky way to revive SustiNet, a controversial, government-run public insurance option neutered in the 2011 legislative session.

Leaders of the State Employees Bargaining Agent Coalition, hoping to prevent thousands of layoffs, managed to schedule an ongoing do-over vote for this month. And with Democratic Gov. Dannel P. Malloy's administration they updated language in the concessions pact to specify that employee health care remains independent of any other plans, particularly SustiNet.

But in the coming months those same labor heads will ask their 45,000 members and 15 unions to vote on what had been a key provision of SustiNet -- pooling. Specifically, SEBAC will, under recent legislation, consider opening member insurance to municipalities on Jan. 1, 2012, and to nonprofits on Jan. 1, 2013.

Sound confusing? That's what some pooling supporters are worried about, given the existing climate.

"It may be more difficult to get the unions to open up to pooling," state Healthcare Advocate Vicki Veltri said. "I do think a re-education campaign is in order once the dust settles on this concessions agreement."

Pooling -- championed for several years by House Speaker Christopher Donovan, D-Milford, a longtime labor ally and current congressional candidate -- is a means of lowering costs through strength in numbers. Cities, towns and nonprofits would, on a voluntary basis, be able to sign employees onto the state health plan if they determined it would be a cheaper alternative to their existing health insurance.

"It doesn't change the benefits," Donovan said. "It's just a way of allowing people to get better benefits at a lower price."

SustiNet relied on a far more ambitious pooling plan, overseen by a quasi-public committee, that would have drawn in Medicaid and HUSKY clients and eventually been opened to businesses and individuals.

Pooling legislation was vetoed by Republican Gov. M. Jodi Rell. But in early July, Malloy, who opposed SustiNet, let a pooling bill pass, unsigned, into law.

State Comptroller Kevin Lembo is in charge of implementation, but not without SEBAC's written consent.

Patrice Peterson, president of a SEBAC union representing 6,000 municipal and public school workers, said pooling has the potential to keep healthcare costs down, but state officials have yet to present a plan.

"Right now we are focused on educating our state employee members about the revised (concessions) agreement (which) clarifies the state health plan is independent and neither the Legislature or the governor have the ability to include it in SustiNet or any other health program," Peterson said.

State Rep. Betsy Ritter, D-Quaker Hill, chair of the legislature's Public Health Committee, said since pooling has been discussed for years -- unions wanted it in the 1990s---- people should be comfortable with the idea.

Ritter noted the legislation requires exhaustive analysis to ensure municipalities and nonprofits are not, "pushing only their sick people into coverage into this pool," driving up costs.

But Jim Finley, head of the Connecticut Conference of Municipalities, believes the SustiNet controversy surrounding the concessions vote will likely complicate the effort.

"I think in many ways it's muddied the waters," Finley said. "The combination of federal legislation and our own state homegrown initiatives -- it's a very confusing time for municipal employers and employees."

And confusing matters further, lawmakers used the pooling bill to establish a cabinet within the lieutenant governor's office to continue examining SustiNet, allowing supporters to claim the matter is not dead.

"I think the (clarified) concessions language helps," Veltri said. "It's very specific in communicating " that state employees will not be involved in an entity or a creature called 'SustiNet'."

Lembo believes that in light of the confusion surrounding the givebacks' impact on workers' health care, pooling supporters need to be more proactive in explaining what it is to rank-and-file union members.

"The 'no' vote was instructive," Lembo said. "All parties " need to do a better job of educating state employees about what these provisions really mean for them and for the people of the state."

Staff Writer Brian Lockhart can be reached at