Connecticut officials are gearing up for sweeping changes to Medicaid, the joint federal-state program that provides insurance coverage for low-income Americans. Medicaid, known as HUSKY in Connecticut, covers around 939,000 residents, or a quarter of the state’s population.

Come January, federal policy changes to Medicaid eligibility — passed as part of House Resolution 1, also known as the “One Big Beautiful Bill” — will go into effect. Many state officials and industry leaders are warning the changes will lead to massive losses in coverage.

The state Department of Social Services, DSS, estimates that roughly 110,000 residents stand to lose their HUSKY coverage unless they can demonstrate compliance with new requirements.

Some Connecticut healthcare providers and local officials are setting up programs that aim to curb coverage losses.

“When people don’t have coverage, they delay care,” said Kathleen Silard, president and CEO of Stamford Health. “It is our obligation and our responsibility to provide this support to the individuals in our community.”

Hospitals also have a financial incentive to minimize coverage loss. Even though the industry has for years been telling the state that the amount they’re paid to treat patients with Medicaid coverage is woefully low, it’s still more financially sustainable than treating patients with no coverage at all. 

Keeping people covered

Stamford Health is teaming up with Mayor Caroline Simmons’ office and nonprofits across the city to launch the HUSKY Stay Covered Task Force, an effort to make residents aware of pending changes. 

Under the new federal policy, beginning Jan. 1, Connecticut residents with HUSKY D — the Medicaid program for low-income adults without dependents — must meet “community engagement requirements” by proving they work at least 80 hours or earn a minimum of $580 per month. 

Enrollees can also fulfill the requirement by demonstrating at least 80 hours of monthly participation in school, community service or a qualified training program. Some people, like those already meeting work requirements for SNAP, or those enrolled in a substance treatment program, are exempt from the work requirements. 

HUSKY D enrollees will also have to prove their Medicaid eligibility every six months, up from every 12 months today. 

Silard said anywhere from 4,000-8,000 Stamford residents are at risk of losing coverage. The task force will work to reduce avoidable coverage loss losses and provide hands-on support for compliance with the new rules. 

Outreach efforts will include advertising and door-knocking. The task force will also place community health workers at various locations across the city to provide information and answer questions. And the task force will work to connect people to work and volunteer opportunities that can help them fulfill the community engagement requirements. 

“The basic idea is that this is a community-wide effort in order to ensure that everyone who is eligible for Medicaid stays connected to care,” said Ben Wade, Stamford Health’s chief strategy officer.

Many people will lose coverage simply because they can’t complete the paperwork — not because they’re actually ineligible, said Sue Lagarde, chief executive officer at Fair Haven Community Health Care, or FHCHC, in New Haven.

“People who clean houses and don’t get a pay stub. Or who don’t work at Amazon and can’t just easily convey to the state that they have a job. They will fail [to prove eligibility] even though they may be working,” she said.

The federal government has stated that the work requirements are meant to help Americans “build skills and independence,” and that they could reduce poverty by as many as 2.9 million people “depending on a variety of conditions such as employment availability.” 

But research in states that have instituted work requirements showed a sharp increase in administrative expenses. Arkansas’ work requirements cost $26.1 million and failed to increase employment, according to a study from the Center on Budget and Policy Priorities, a left-leaning think-tank.

Roughly 2,800 FHCHC patients have HUSKY D coverage, Lagarde said, and the community health center has already started to reach out to them about the pending changes. 

Fair Haven is using a few different strategies to help keep as many people covered as possible. 

First, the team is assessing whether any HUSKY D enrollees are eligible for coverage through HUSKY C, the Medicaid program for people with disabilities. This way, they can switch coverage and avoid the new work requirements altogether. 

Certified application counselors will also be on hand at FHCHC sites to help support people through the eligibility and redetermination processes once those begin next year. The organization will also create a small number of volunteer opportunities to help people meet the community engagement requirements.

But, Lagarde wants patients to know that federally qualified health centers like Fair Haven will continue to provide the same care to people who lose their Medicaid coverage, regardless of their ability to pay.

“They’ll see their same clinician [and get] the same services. Everything will be the same, at least within our four walls,” she said.

Click here for a pre-screener from the state Department of Social Services to find out if Medicaid changes apply to you and here for additional resources on the policy changes from the Connecticut Hospital Association.