Voting along party lines, legislators adopted an omnibus bill to implement numerous social service policy changes in the next state budget, including the end of a health coverage program launched by former Gov. M. Jodi Rell to help the uninsured.
One thing it doesn’t change: Medicaid eligibility for low-income parents. Gov. Dannel P. Malloy had proposed restricting eligibility for the program, a move that would have caused an estimated 37,500 parents to lose Medicaid coverage. But legislators didn’t embrace the idea. Instead, parents who already receive the public health care coverage will maintain it while the state expands Medicaid to thousands of other poor adults as part of the federal health reform law taking effect Jan. 1.
The House of Representatives approved the bill Tuesday night, and the Senate voted shortly before 1 a.m. Wednesday. Majority Democrats supported the proposal, while minority Republicans opposed it.
Among the changes in the bill is the elimination of the Charter Oak Health Plan, Rell’s program, as of Jan. 1. The move was not unexpected: Officials had anticipated that the program would end once federal health reform rolls out.
Created in 2008 and intended to reduce the state’s uninsured population, Charter Oak attracted an older and sicker population than expected. In 2010, legislators prohibited the state from subsidizing the program, and premiums rose significantly. At its peak, Charter Oak had more than 14,500 members. Last month, it was down to 4,669.
Charter Oak enrollees are expected to have other coverage options beginning Jan. 1. These include Medicaid, which will be expanded to cover more low-income adults without minor children, and insurance sold through a new marketplace known as the exchange, possibly with federal subsidies.
Neonatal transport and screening for children
The policy bill also allows the UConn Health Center to discontinue its neonatal transport program to save as much as $100,000 in firefighter and paramedic overtime costs.
Currently, the health center’s fire department operates the program, which provides specialized medical care and transportation for newborns — many of whom are premature — who need to be transferred to hospitals that provide higher levels of care.
Since 2011, Connecticut Children’s Medical Center has operated the neonatal intensive care unit at UConn’s John Dempsey Hospital, and the children’s hospital is expected to begin its own neonatal transport service this month.
The bill also requires the Department of Children and Families to ensure that children 3 or younger who have been abused or neglected receive screenings for developmental and social-emotional delays at least twice a year. Children found to be exhibiting delays would then be referred to the state’s birth-to-three program or other programs.
Advocates for children have been pushing for such screenings as a way to ensure that those who need help get it as early as possible.
Belt-tightening for health care providers
The policy bill spells out several belt-tightening measures, big and small, for a variety of health care providers:
- Nursing homes and residential care facilities for people with developmental disabilities would have their rates frozen, eliminating a $138.6 million pay increase they’d been scheduled to receive over the next two years.
- Hospice rates paid by Medicaid would be reduced.
- Independent pharmacies would lose the enhanced payment rates they get from Medicaid, saving the state $1.1 million per year.
- Many health care professionals, including doctors, nurses and dentists, would see a $5 increase in the fees for renewing their licenses.
In addition, some Medicaid recipients would be charged co-payments if they use hospital emergency rooms for nonemergency purposes. Federal law allows charges of up to $7.90, although some people would be exempt, including children. It’s anticipated to save the state $675,000 per year.
There are some health care spending increases in the next budget. Community health centers would see rate increases totaling $10 million a year. The health centers largely serve the uninsured and people on Medicaid, and are expected to see a significant increase in demand for services once more people gain health care coverage under health reform.