Starting in October, Connecticut will institute stricter income standards for HUSKY A, Medicaid coverage for relatives who are the parents or guardians of eligible children.
Currently, parent and guardian relatives who earn up to 160% of the Federal Poverty Level (FPL) are eligible for HUSKY A. However, legislation passed last session, proposed and supported by Gov. Ned Lamont, would lower the eligibility threshold to 138% of the Federal Poverty Level starting Oct. 1, 2024.
About 15,300 people will lose their HUSKY coverage, according to a recent summary released by the Connecticut Health Foundation, but most of those people will continue to have Medicaid coverage for one more year under a program called Transitional Care Assistance.
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Most people would then be eligible for Covered Connecticut’s zero-premium, no-cost insurance plans through Access Health CT, the state’s health insurance marketplace, a program that provides free health insurance to residents earning less than 175% of the FPL.
According to the Lamont Administration, Connecticut is currently the only state that offers Medicaid coverage to parents and kinship caregivers at more than 138% of the FPL. Bringing eligibility standards in line with other states would save $2.1 million in fiscal year 2025 and $33 million on an annual basis thereafter.
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“This benefits everyone by making better use of the state's limited budget while preserving zero-premium, no-copayment health care through private insurance for HUSKY A adults,” Chris Collivey, a spokesman for the Office of Policy and Management, said in emailed comments.
Collivee said the policy will “cost Connecticut taxpayers less than the cost of HUSKY A” and help strengthen Access Health CT. The program “covers out-of-pocket costs that the federal government doesn't cover, as well as dental care and non-emergency medical transportation services,” Collivee said.
“This plan will take advantage of federal funding already available under the plan, so the cost to Connecticut taxpayers will be less than it would be under the HUSKY A plan.”
But advocates worry the changes could affect access to health care for some low-income residents.
“Covered Connecticut is a great option for people who make just above the Medicaid limit and who haven't been able to get insurance at affordable premiums before,” said Tiffany Donelson, president and CEO of the Connecticut Health Foundation, “but it works best as a way to give people more options for getting insurance, not a mechanism to cut back on HUSKY.”
Many parents and guardians who lose their HUSKY insurance would qualify for Covered Connecticut, but some would not, according to a policy brief released by the Connecticut Health Foundation. Covered Connecticut is only available to people who don't have access to alternative insurance, such as Medicare or employer-sponsored insurance.
For example, some grandparents who are over 65 and eligible for Medicare and who are caring for their grandchildren don't qualify for Covered Connecticut. They also don't qualify if their employer provides their health insurance, even if it's a high-deductible plan. However, under the Affordable Care Act, even people with employer-sponsored insurance can qualify for Covered Connecticut if their premium payments exceed 8.39% of their income.
The report also warns that federal funding supporting Covered Connecticut is set to expire at the end of 2025 unless Congress and the president extend the funding.
Sen. Matt Lesser, a Middletown Democrat who co-chairs the Human Resources Committee, said he doesn't agree with the change. While Connecticut has higher eligibility standards than any other state, Lesser said covering both parents and children is good policy.
“It's very odd to cut people off from Medicaid when we have a surplus in the budget,” Lesser said.
State Sen. Matt Lesser's son plays as he talks with Connecticut State University President Dr. Terrence Cheng, who speaks outside the Senate chamber on the final day of the session at the Connecticut State Capitol, Wednesday, May 8, 2024. (Aaron Flaum/Hartford Courant)
Lamont introduced the measure in his budget proposal last session, but it failed to pass as part of the Human Resources Committee bill. Then, during budget negotiations, the governor successfully lobbied to have the provision included in the final ARPA package, Lesser said.
The move is the latest in a series of decisions that have Medicaid expansion advocates questioning Gov. Lamont's approach to the program.
The governor has yet to support increasing Medicaid reimbursement rates, which have near-universal support from health care providers and lawmakers in both parties, and the governor recently began exploring the possibility of privatizing the state's Medicaid program amid strong opposition from the Medicaid Program Oversight Board.
“I think the governor has to think about whether he's interested in Medicaid,” Lesser said. “Medicaid costs a lot of money. He can expand access, or put money into fees, or he can do both. But if he doesn't do either, it leaves me questioning whether he's serious about the program.”
Colliby, the OPM spokesman, said the governor has been working with the Legislature to fund the Medicaid expansion, including $7 million to increase Medicaid reimbursement rates, new fees for emergency crisis centers and $17 million in ARPA funding for children's behavioral health.
The administration also wants to ensure that the fee increases are used effectively.
“Medicaid costs continue to increase significantly, not only due to increased enrollment and utilization, but also legislative additions and program expansions. If rates are going to increase, Connecticut taxpayers deserve to know they are getting improved services, including access, not just paying more for the same services,” Colliby said.
A policy brief from the Connecticut Health Foundation recommended several specific strategies to minimize loss of insurance during the transition to HUSKY A, including identifying people who don’t qualify for Covered Connecticut, using navigators to help people enroll in new insurance, and planning for the possible expiration of federal subsidies.
The Department of Human Services is working to prepare for the transition by working with Access Health CT to track and support people who are not automatically enrolled in Transitional Care Assistance or Covered Connecticut, said Peter Hadler, deputy secretary of the Department of Human Services.
We're also working to get the message out about the changes. DSS will contact you via email and text to let you know about the changes and to offer help enrolling in coverage. DSS and Access Health CT will post information about this process on their websites and social media.
“We have a shared goal of ensuring that eligible individuals can continue to have health insurance through HUSKY, Covered CT or a qualified health insurance plan,” Hadler said in emailed comments.
Editor's note: CT Mirror is supported by a grant from the Connecticut Health Foundation.
Katie Gorvara is a reporter for the Connecticut Mirror ( https://ctmirror.org/ ). Copyright 2024 © Connecticut Mirror.
