Four months after a major change in Medicaid eligibility for poor parents, 39 percent of those initially expected to lose Medicaid coverage are still in the program and 16 percent have coverage through the state’s health insurance exchange.
The health care coverage status of another 42 percent of those affected by the cut – 7,872 people – is unknown, officials from the state Department of Social Services and Access Health CT, the exchange, told the council that oversees the Medicaid program Friday. Officials said people in that group could be covered by employer-sponsored insurance, might have moved out of state, or could be uninsured.
The eligibility cutback was made as part of the two-year budget passed in 2015. Gov. Dannel P. Malloy’s administration argued that parents losing coverage would be able to buy insurance at deeply discounted prices – subsidized by federal funds – through the exchange, and legislators, many of whom initially opposed the change, agreed. Critics of the cut warned that many parents losing Medicaid coverage would be unable to afford even deeply discounted insurance and would become uninsured.
The change scaled back eligibility for parents of minor children from 201 percent of the poverty level to 155 percent. For a family of four, that changed the income limit from $48,742 to $37,587, based on 2015 poverty-level figures. (The eligibility criteria for children did not change, nor did the income limit for pregnant women.) Because federal rules allow those with earned incomes to maintain an additional 12 months of coverage, the cut took place in two stages, with the vast majority of those affected covered until July 31.
The legislation that included the cut also required officials to report information on the coverage status of parents affected by the cut.
Overall, there were 18,903 parents with household incomes that placed them above the new income limit for Medicaid, known in Connecticut as HUSKY.
Of them, 7,343 were still covered by HUSKY as of November. In some cases, people maintained eligibility because their incomes were lower than had previously been reported. In other cases, clients were eligible for the program for other reasons, such as having a disability or being pregnant.
Another 3,103 people are covered by private insurance plans sold through the exchange. More than one in three did not enroll in that coverage immediately after losing Medicaid, but subsequently signed up.
In addition, 585 parents signed up for private insurance through the exchange but were no longer enrolled as of November, either because they canceled voluntarily, did not make their payments or failed to verify the required information to maintain coverage.
The Medicaid oversight council’s discussion Friday largely focused on the 42 percent whose coverage status was not clear.
“We don’t know where they are within the health care system,” said Robert Blundo, director of technical operations and analytics for Access Health.
He said past surveys of exchange customers who gave up their insurance indicated that 60 percent had other sources of coverage, although Blundo acknowledged that that pool of people had higher incomes than those who lost HUSKY.
Katherine S. Yacavone, president and CEO of Southwest Community Health Center in Bridgeport, said most of the affected parents who go to community health centers have not gotten coverage. Health centers charge on a sliding scale for those without insurance.
“The majority of the clients that we’ve seen cannot afford the [private insurance] premiums, so by default they’re uninsured,” she said.