January 2, 2019

Report calls for changes to CT’s Medicaid program for children

The percentage of Connecticut children who lack health insurance ticked up in 2017, following three years of consecutive declines.

A new report, authored by a Georgetown University researcher and released Wednesday by the Connecticut Health Foundation, issued several prescriptions for reducing the count of uninsured youths, which stood at approximately 24,000 as of 2017, a number that has increased after state legislators tightened Medicaid eligibility requirements in 2016.

Research cited by the report has shown that health coverage for children pays off down the road in the form of reduced hospitalizations and emergency room visits, and higher educational attainment and employment levels.

Connecticut's Medicaid program, which covers more than 330,000 vulnerable and disadvantaged children, ranks high in quality measures, but several key tweaks would improve health outcomes, quality tracking and program efficiency, according to the report, authored by Tricia Brooks, an associate research professor at Georgetown's McCourt School of Public Policy Center for Children and Families

One of the report's biggest recommendations says Connecticut should implement a "continuous eligibility" policy for its Medicaid and Children's Health Insurance (CHIP) Program.

Such a policy, which has been enacted by about two dozen other states, would ensure children don't suddenly lose Medicaid or CHIP coverage, such as in the event of a parent's income increasing or some other status change. Continuous eligibility would cover any child in such a scenario until his or her parents' next annual renewal.

"If low-income children lose coverage and their families are unable to afford doctor visits or to fill their prescriptions for even a month or two, they can become sicker and eventually require emergency room or hospital inpatient care," Brooks wrote. "Already Connecticut experiences a rate of emergency room use that is among the highest in the country. The lack of 12-month continuous eligibility may contribute to this poor ranking."

Just how much continuous eligibility would cost Connecticut isn't entirely clear. The report said there isn't enough publicly available data to calculate it.

However, the report said a recent study pegged the increase of such a policy at 2.2 percent a year, and that longer-term benefits, not just short-term cost increases, should be determining factors for policy makers.

The "HUSKY A" program, which covers the vast majority of children in Connecticut's Medicaid program, had an average annual cost of $3,600 to $4,668 per client between Sept. 2012 and Dec. 2016, according to state data analyzed by the Connecticut Mirror.

Meanwhile, the report also recommends streamlining the administration of various Medicaid and CHIP programs and expanding CHIP coverage to more women. The latter move would be aimed at reducing the state's infant mortality rate, which at 4.8 deaths per 1,000 births, is lower than the national average, but much higher for black and Hispanic children, and also reducing the rate of low-weight births in the state.

"While there is much to be proud of in the state's commitment to children's health, this report shows there is more work to be done," Connecticut Health Foundation CEO Patricia Baker said. "Connecticut should aspire to move from 12th to 1st in the rate of uninsured children and to improve the quality of care and health outcomes for all children. This report provides strategies that can help get us there."

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