May 16, 2018

Report: CT's Medicaid expansion increased coverage, care access

PHOTO | Contributed
PHOTO | Contributed

The decision by Connecticut leaders to expand Medicaid in 2010 to low-income adults without dependent children reduced the state's uninsured rate and drove greater use of preventive health services and behavioral health care by those patients, according to a new report released by the Connecticut Health Foundation.

The report examines the impact of "Husky D," as the Medicaid expansion is known, and found more than 200,000 state residents, ages 19-64, were covered under the plan as of 2017. Of those, 18,404, were in Hartford, which had the highest number of Husky D enrollees in the state. Connecticut's total Medicaid program, comprising Husky A, B, C and D, covers more than 750,000 people.

Before Husky D, low-income adults who didn't get health insurance through an employer had few coverage options, the report said, noting they could buy insurance through the individual market, but insurers were allowed to deny people with pre-existing conditions prior to Obamacare's reforms that kicked in around the time of the Husky D expansion. The state pays 6 percent of the cost of coverage for Husky D this year, which will cap at 10 percent in 2020, barring changes in federal law, the report said. The federal government pays the balance.

The report found:

  • Husky D reduced Connecticut's uninsured rate from 9.1 percent to 4.9 percent from 2010 to 2016.
  • More than 80 percent of people with Husky D used the coverage for preventive or outpatient health services in 2016.
  • Emergency department visits (often more costly than outpatient care) among Husky D members fell 36 percent from 2002 to 2016.
  • A sample of more than 500 Husky D members with diabetes found the percentage whose blood glucose was under control rose from 31 percent to 50 percent from 2012 to 2016.
  • 36 percent of Husky D members used their coverage in 2016 to get care for mental health condition or substance use disorder.

While Husky D members have made use of their coverage, their use of outpatient and preventive services were lower than those of privately insured residents, which the foundation says indicates that more work is needed to ensure care is received.

However, healthcare officials are concerned that Medicaid paid the state's hospitals about 61 cents of every dollar of cost for care, making it a challenge to cover a high rate of Husky patients, the report acknowledged.

The foundation said that if the federal government changes its Medicaid funding formula from agreeing to pay a percentage of overall costs to providing a fixed allotment to states, Connecticut's ability to maintain coverage for Husky D residents could be challenged, the report said.

Link to report here.

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