Connecticut cities as well as towns in the western part of the state are at greatest risk of increased insurance costs and coverage losses resulting from federal health policy changes, according to a new report.
In the report, published this week by statewide data organization DataHaven and advocacy organization Health Equity Solutions, the authors analyzed the projected impacts on Connecticut of new Medicaid eligibility requirements and the expiration of financial assistance for Affordable Care Act plans.
Both issues have defined health policy debates during Trump’s second administration. The Medicaid work requirements were a centerpiece of the spending cuts in the “One Big Beautiful Bill Act,” while the showdown over extending ACA subsidies led to the longest federal government shutdown in history.
Beginning Jan. 1, the new work requirements will apply to enrollees in Medicaid’s HUSKY D program, which covers poor adults without children. To maintain coverage, they must show proof of working at least 80 hours, or earning a minimum of $580, per month. Or they must demonstrate at least 80 hours of monthly community service or participation in a qualified training program. Several exemptions exist.
The state estimates that more than 100,000 residents are at risk of losing Medicaid coverage unless they can demonstrate compliance. Hartford, Waterbury, New Haven and Bridgeport have the highest rates of residents in danger of losing Medicaid coverage, according to the report. In general, the changes will have the largest impacts in cities with concentrated populations of low-income families and immigrants.
One Medicaid change passed as part of H.R. 1 has already taken effect. As of Oct. 1, the program no longer covers several groups of lawfully present immigrants, including refugees, asylees and victims of human trafficking. The report estimated that 3,200 Connecticut residents lost HUSKY coverage as a result of the change, with the highest rates of coverage losses occurring in Bridgeport, Waterbury, Hartford and Danbury.
Meanwhile, towns in the western part of the state with some of the highest rates of self-employed workers are projected to be disproportionately harder hit by higher premiums following the expiration of COVID-era ACA subsidies at the end of 2025.
Cornwall, Bridgewater, Roxbury and Warren are the towns with the highest rates of people at risk of premium increases. These towns have high rates of self-employed workers, who are more likely than private-sector employees to have an ACA plan. The towns in the western part of the state also skew older, and older people are more likely to be self-employed, according to the report.
When the subsidies expired, people who qualified and made over 400% of the federal poverty level annually stopped receiving financial support from the federal government. People making less than 400% of the federal poverty level still receive financial support, but it was reduced.
The figures provided in the report do not account for Temporary Premium Assistance, a fund created by the state government in 2026 to provide some financial assistance to certain residents who lost it. Gov. Ned Lamont recently extended that financial assistance for another year.
