Few who lost Medicaid have purchased insurance

Volunteer Maria Hernandez helps a woman sign up for health care insurance during an event in Windham.

Arielle Levin Becker

Volunteer Maria Hernandez helps a woman sign up for health care coverage during a 2013 event in Windham.

When state lawmakers scaled back Medicaid eligibility for thousands of low-income parents earlier this year, they argued that the parents could instead buy deeply discounted coverage through the state’s health insurance exchange. But so far, just 140 of the nearly 800 who lost coverage this month have signed up – fewer than 20 percent.

Those who lost Medicaid coverage Sept. 1 have until Oct. 1 to sign up for private health insurance. But unless they found alternative forms of coverage, they’re likely uninsured now, said Jim Wadleigh, CEO of the exchange, Access Health CT. That’s an outcome critics of the cut warned could happen.

When asked why more people hadn’t signed up, Wadleigh pointed to cost.

“It’s expensive,” he said. “I think even if it’s $10 a month, that’s still a lot of money.”

The cut to Medicaid eligibility affects parents of minor children with income above 155 percent of the poverty level, the equivalent of $37,587 for a family of four. Gov. Dannel P. Malloy proposed cutting eligibility earlier this year, and legislators agreed to the cut – smaller than Malloy’s original proposal – to help balance the budget.

Although the number of people who lost Medicaid coverage this month is relatively small, another 18,550 people are expected to lose coverage next summer, and officials have said they’re hoping to learn from the experience of the smaller group to better handle the next, larger cut.

In all, the cut to the state’s Medicaid program – known as HUSKY – is expected to affect approximately 19,750 parents. It’s occurring in two phases because the vast majority of those parents qualify for 12 months of additional coverage, something required under federal law for people with wages from a job or another source of earned income.

The other 1,200 parents, who don’t have earned income, were slated to lose HUSKY coverage Sept. 1. But about 400 were found to qualify for continued Medicaid coverage; pregnant women are not subject to the cut, for example, and others could have income that is now below the cutoff level. Another 80 were deemed to be potentially eligible for a portion of the Medicaid program for people with disabilities, according to the state Department of Social Services.

The weeks leading up to the termination date included confusion among some clients. Some termination notices were sent incorrectly to people who were not scheduled to be cut off this month, state Healthcare Advocate Victoria Veltri said.

Workers in the exchange’s call center attempted to call all of those who were slated to lose HUSKY.

Wadleigh, the exchange CEO, said the call center would conduct another round of calls to about 400 people for whom they had previously left voicemails, in hopes of helping them sign up for insurance.

Wadleigh said there was an indication that outreach efforts have been kicking in. As of Aug. 20, fewer than 100 people had signed up for coverage through the exchange. As of Wednesday, 140 people had.

What will coverage cost them?

With federal tax credits to discount monthly premium costs, two parents in a family of four earning $39,000 per year would pay $153 per month for a plan with discounted cost-sharing and an $800 deductible. Their cheapest premium option would cost far less: $1.44 per month. But that would come with a $12,400 deductible, requiring them to pay that sum before the plan pays for any non-preventive care. (For $1.69 per month, they could get a plan with a $6,000 deductible.)

The results so far appear similar to the experience in Rhode Island, Wadleigh said, calling it unfortunate. When that state lowered its Medicaid income limit, 11 percent of those expected to lose coverage had enrolled in the state’s exchange four months later, according to an analysis by researchers from the University of Massachusetts Medical School’s Center for Health Law and Economics, conducted on behalf of the Connecticut Health Foundation.

The researchers noted that while many were probably uninsured, others had remained eligible for Medicaid or had signed up for employer-sponsored coverage.

Connecticut’s HUSKY eligibility level for children is not changing, but the researchers warned that the cut could nonetheless affect children. Maine reduced Medicaid eligibility for parents in 2013, they wrote, and within 7 months, the number of children enrolled dropped by 13 percent, even though eligibility limits for children had not changed.

Asked about the sign-up rate, Malloy spokesman Devon Puglia said, “the budget was filled with tough choices.” He noted that Connecticut still has one of the highest Medicaid eligibility thresholds in the country and said the state continues to provide “top-notch” Medicaid services. He also noted that Connecticut’s exchange is considered a model for other states.

“There are options – quality options – out there for families and it’s our hope that they utilize them,” Puglia said.

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