Connecticut’s Medicaid program provides coverage for needed medical care to more than one million Connecticut residents. But there are some glaring inequities that currently exist in the Medicaid program and bills pending before the Connecticut legislature could help to address these.
But only one of the bills actually ends the injurious discrimination against people with disabilities and older adults, while the other perpetuates it– just to a lesser degree.
There are several different Medicaid programs in Connecticut, and which program you are eligible for depends on whether you are a parent/caregiver, your age, whether you are disabled, whether you have a particular medical condition, and whether you work. Each program has income limits and two (those applicable to people with disabilities) have asset limits. You might be surprised to know that the Medicaid program with the lowest income and asset limits is the program for people who are elderly and/or disabled and unable to work – the folks generally considered the most vulnerable — HUSKY C.
HB 6630, which has passed out of the Human Services Committee and is currently with the Appropriations Committee, would raise the income limit for HUSKY C to 138% of poverty (currently $1,677/month), matching the income limit for the HUSKY D program (which covers adults who are under 65 and generally are not disabled) and would raise the asset limit to $10,000 for a single individual/$15,000 for a couple to match the MED-Connect program (which covers disabled people who also have earned income). This proposal is the right, fair, and just thing to do and it follows the lead of New York and California, which have already ended discrimination thereby raising the income limits for their Medicaid programs for elderly and disabled folks to 138% of federal poverty levels.
If budgets are a moral document, and people want to ensure the health of the “most vulnerable” residents of Connecticut – something every legislator claims to want to do – then the right thing to do is to pass HB 6630. And if we are serious about addressing the well-documented gaps in access to health care for Black and brown people, who have higher rates of disability and generally lower incomes than their white counterparts, then we also need to help address these disparities by fully addressing the discrimination against people with disabilities in the eligibility for HUSKY C compared with HUSKY D.
There is an alternative proposal as part of HB 5001, but it does not raise the income and asset limits for HUSKY C to the same levels as the proposal in HB 6630. It’s a partial fix. If the current design of the program represents systemic discrimination against older adults and adults with disabilities –- which we contend it does –- then a partial fix means perpetuating that pattern of discrimination. That’s unacceptable and that’s why the language in HB 5001 needs to be changed to incorporate the language of HB 6630.
There are a lot of competing claims for the surplus in the budgets. But why is it that the people who seem to be last in line are the people who most desperately need the help? Someone who is no longer able to work due to a disability and receives a modestly higher disability benefit from Social Security due to their own work history likely needs access to medical care to address chronic health conditions and may be at risk of institutionalization if they don’t have access to the long-term services and supports that are covered by Medicaid.
When they are unable to access care because they don’t have Medicaid coverage and can only access it through the process of “spending down” their “excess income”– they suffer. Or they end up at the emergency room, incurring a large bill, which ironically may help them meet that spend-down and then have access to Medicaid until the next six-month spend-down period starts.
There is no way, if one were designing a program from scratch, that it would be designed like this. The current system literally incentivizes the use of one of the most expensive parts of the health care delivery system, the emergency room, because ERs are required to stabilize someone who shows up at their door. We could instead ensure that people have full access to needed care. We could also enable people to save additional money to be able to address emergency expenses or a security deposit on a new apartment rather than having to keep their savings below an extremely low asset limit ($1,600) that was literally set in the early 1970s.
HB 5001 is only a partial solution, nickel and diming needy individuals. It still discriminates on the basis of disability and age. A somewhat reduced level of discrimination is still discrimination. We are better than that.
We urge the Appropriations Committee to include funding in their budget for raising the income and asset limits for HUSKY C as outlined in HB 6630.
Catherine John is with Black and Brown United in Action. Holly Hackett is Support and Outreach Coordinator for the Keep the Promise Coalition.