By Max Friedman
When Access Health CT’s Board of Directors met last Thursday, June 18 they learned the exchange’s plans for transitioning thousands of current Medicaid enrollees to private insurance, the upcoming open enrollment period this fall, and recommendations for the essential health benefits plan for the exchange. Here are some of the highlights.
King v. Burwell and its impact on CT
We don’t yet know what the impact of the King v. Burwell case currently before the U.S. Supreme Court will be, though Access Health CT CEO Jim Wadleigh told the board that he was monitoring it and doesn’t expect any short-term implications for Connecticut either way. Wadleigh said that he is in regular contact with other state exchanges regarding collaboration, and will be leading a state-based marketplace conference in Washington, DC later this summer.
Preparations for Changes in HUSKY
In the recently passed budget, the legislature lowered the ceiling for HUSKY A. Access Health CT and the Department of Social Services are coordinating a marketing and enrollment plan to transition those enrollees to private coverage on the exchange. They estimate that 1,350 people will need to enroll in private plans by August 15 to have no gap in coverage on September 1. Most are expected to receive Advance Premium Tax Credits and cost sharing reductions in their new plans. Another 23,000 are expected to lose Medicaid coverage a year later.
Keeping those transitioning between coverage plans is a big challenge. Other states that have gone through similar Medicaid changes, and less than half of those who transitioned to private health insurance retained coverage. In Rhode Island, only 11% of those moved from Medicaid to private insurance kept their coverage. Access Health CT will be working with the Department of Social Services, the Office of the Healthcare Advocate, insurance carriers, and the Connecticut Health Foundation to mitigate the risk of individuals falling through the cracks.
Marketing and Upcoming Open Enrollment
Access Health CT is preparing for the next Open Enrollment period, set to begin on November 1 and run through January 2016. Over the summer, they are running “Get Out, Get Active, and Get Healthy,” an outreach program to encourage Connecticut residents to lead healthy lifestyles. Access Health CT marketing staff have had a presence at events this to boost awareness of Access Health CT and the importance of signing up for health insurance coverage.
Essential Health Benefits
The Board heard Access Health CT’s recommendations for the state’s Essential Health Benefits (EHB) benchmark plan for 2017. This is a benchmark set by the state to ensure that health insurance plans comply with federal and state coverage mandates for certain services, including maternity and newborn care, lab services, prescription drugs, and behavioral health care services. All plans offered to the public, both on and off of the state exchange, must provide these benefits. Access Health CT looked at a variety of federal and state plans, including those on by the Federal government’s exchange. Access Health CT recommended, and the Board approved, an EHB benchmark based on two small group carrier plans, which maintains the current benchmark plan service levels.
More to Come
Over the next few months, we can expect to hear more about Access Health CT’s plans for the next open enrollment period, possible collaborations with other states, and plans to integrate policies in SB 811. Check back here for updates on future developments.