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May 9, 2023

Connecticut is weighing several changes to Medicaid. Here’s a look at some of them


Medicaid, known as HUSKY in Connecticut, provides health coverage to people with incomes below certain thresholds. Over a quarter of Connecticut residents currently receive coverage through Medicaid.

The Connecticut General Assembly has proposed several changes to the state’s Medicaid program this legislative session. Here’s an overview of what they are and where they stand as the session enters its final month.

HUSKY insurance for immigrant children

The legislature’s Appropriations Committee has proposed setting aside $3 million to expand Medicaid coverage for children, regardless of immigration status, from age 12 to 15 starting in July 2024.

Connecticut currently offers Medicaid to children without permanent legal status who are 12 and younger. Lawmakers introduced a bill earlier this session that would have extended the age to 20 beginning in January 2024, and then to age 25 by June 2024. Before the bill was voted out of the Human Services Committee, however, the age limit was changed to 18.

The Appropriations Committee’s budget proposal would again adjust the age limit, to 15.

Supporters of the expansion said they were disappointed by the latest recommendation, and they are pressing for a broader age limit before the session ends in June.

“Expanding coverage for immigrants up to age 15 is only going to impact a small amount of youth who are not already currently covered by the recent expansion up to 12,” said Carolina Bortolleto, a volunteer with the HUSKY for Immigrants Coalition and a co-founder of Connecticut Students for a Dream. “We definitely feel that expanding to age 15 is not enough. I don’t think that expanding to age 15 has a true impact on health equity in our state. … It shouldn’t be acceptable to folks who want to promote health equity in this state.”

Medicaid reimbursement rate increases for specialists

The Appropriations Committee proposed earmarking $9.2 million in fiscal year 2024 and $18.3 million in fiscal year 2025 to fund an increase in Medicaid reimbursement rates for physician services.

The proposal would bump them to 65% of Medicare rates as of Jan. 1, 2024. Most specialists currently receive 57.5% of 2007 Medicare rates for care provided to patients on Medicaid. This would represent the most significant increase in Medicaid reimbursement rates that most specialists have seen in nearly two decades.

The rate increases fall slightly below those passed by the Human Services committee in House Bill 6885, which proposed raising the rates to 75% of Medicare by fiscal year 2025, with the eventual aim of getting them to 100% of Medicare by July 1, 2027.

During the bill’s public hearing, several physicians testified to explain how the low reimbursement rates can force them to see fewer patients on Medicaid or, in some cases, stop seeing them altogether.

“This might be one of the most important things we’re talking about right now in this entire legislative session,” said Rep. Michelle Cook, D-Torrington, during the Human Services committee vote on the measure. “We’ve heard begging and pleading on the increase of rates, and if we do not increase rates, people are going to go without services, people are going to go without care that they need.”

Medicaid reimbursement for community health workers

Community health workers, also known as outreach workers, health coaches, patient navigators and promotores de salud, help people navigate health care and social services. They have an encyclopedic knowledge of all the resources available to residents in need, and they are experts in navigating the infinite obstacles that can come up when trying to access them.

Currently, the funding for their roles is piecemeal and largely sustained through grants, which can be insufficient and unreliable. But two bills currently under consideration by the legislature aim to make it easier for organizations to employ community health workers by making their services reimbursable by Medicaid.

Medicaid reimbursement for community health workers is proposed as a stand-alone measure in Senate Bill 991 and as part of the Democrat caucus Senate Bill 10.

Health Equity Solutions and the Community Health Workers Association of Connecticut spent a year talking to community health workers about the best way to structure Medicaid reimbursement for their work. Those conversations shaped SB 991.

SB 10 passed the Appropriations Committee and now heads to the Office of Legislative Research and Fiscal Analysis for a fiscal note.

Legislators eventually plan to substitute the CHW-related language in SB 10 with the language from SB 991, which has some minor differences, including a statement guaranteeing that people with disabilities won’t be denied services.

Increases for HUSKY C income and asset limits

The state’s eligibility criteria for HUSKY C, the Medicaid program for people who are over 65, blind or disabled, requires non-working people to remain in poverty and severely limit their savings in order to keep their Medicaid coverage.

To qualify, residents must effectively earn less than $1,182 per month, around 97% of the federal poverty level. Individuals must have less than $1,600 in assets, and couples must have under $2,400.

This session, the human services committee passed two different proposals to increase both the income and asset limits for HUSKY C, but only one will go to the floor for a vote.

The first, included as part of House Bill 5001, proposes raising the income limit from $1,182 to a fixed rate of $1,465 per month and the asset limits to $3,600 for a single person and $5,400 for a couple. The bill passed the Appropriations Committee last month.

Several advocates believe this change would provide inadequate relief because it raises the income limit to a fixed amount, the value of which would erode with inflation.

The second proposal, House Bill 6630, sought to bring the HUSKY C income limit up to the same level as the HUSKY D income limit, which is set at 138% of the Federal Poverty Level, currently $1,677 a month. The bill would also have brought the asset limits up to $10,000 for an individual and $15,000 for a couple.

Even though it had the support of advocates, House Bill 6630 failed to make it out of the appropriations committee. But several high-ranking lawmakers said they hoped to replace the language in House Bill 5001 with the higher limits proposed in 6630.

“We have the capacity to end this historic discrimination,” said Sen. Matt Lesser, D-Middletown, who co-chairs the human services committee. “It’s just a question of whether we have the will.”

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