We Can Do Better

By Rosana Garcia

thumbs downDespite a year to prepare, Access Health CT’s outreach to HUSKY A parents losing coverage July 31 is sorely lacking – as of July 1st, only 15% of those losing Medicaid have new coverage in place.

While there may be some “shock” that so few people have enrolled and that Access Health CT’s (AHCT) enrollment fairs are poorly attended, the reality is that advocates saw this coming.

There are some basic best practices to engaging people and the Department of Social Services (DSS) and Access Health CT (AHCT) followed few of them.  It is likely that notices of losing coverage sent from DSS were hard to understand.  AHCT’s one-day enrollment fairs during working hours are often not a viable option for those who are working – even if those losing coverage were able to decipher DSS’ notices.

The special enrollment period for these parents losing coverage didn’t even begin until mid-June, despite the fact that it has been known for a year that this would be happening.

What about all those in-person assisters that AHCT had available during the first round of enrollment back in 2013?  Despite recommendations made in a Community Alliance for Research and Engagement (CARE) evaluation of enrollment in Connecticut*, AHCT discontinued their in-person assisters program.

In circumstances such as this one, where there are thousands of individuals who will need to transition to private insurance, a network of assisters embedded in the community is even more sorely missed.

And let’s not fool ourselves into thinking that even with the best outreach that all of these parents losing HUSKY coverage would enroll in private insurance.  Do you know why?

Because health insurance coverage is unaffordable for low-income people.

Think about it – even middle-class families are feeling the squeeze of plans with high-deductibles, rising prescription drugs costs, monthly premiums, and other out-of-pocket expenses.  How does someone making just over 155% of the federal poverty line (that’s under $2604 for a family of 3) add a monthly premium to their household budget?  Subsidies or no subsidies, it’s just an unrealistic expectation.

DSS could have done a better job communicating with parents losing coverage.  Access Health CT could have created a deeper engagement plan that utilized skilled community-based outreach.  And the state of Connecticut could have chosen to keep HUSKY A parent eligibility the same.

This is a failure – and it’s our families, our children, who will pay the price.

* Please note that the CARE report was funded by Universal Health Care Foundation of Connecticut, Connecticut Health Foundation and The Donaghue Foundation.

A Little Background

In the 2015 legislative session, the budget that was finally approved included cuts to HUSKY A, which covers children and their caregivers.  Where before parents making below 201% of the federal poverty line were eligible for HUSKY A, now only parents making below 155% of the poverty line will be eligible moving forward.

So if this happened last year, why are parents losing coverage now?  Because many of the parents on HUSKY A were eligible for a program called Temporary Medical Assistance (TMA), where, if they were working, they could keep their HUSKY A benefits for another year before being ineligible.

TMA kicked the can down the road to this upcoming July 31.  Parents who will be ineligible for HUSKY A will need to enroll in private insurance coverage via Access Health CT, or go without insurance, potentially paying a penalty at tax time. 

This entry was posted in From the Foundation, Rosana G. Ferraro and tagged , , . Bookmark the permalink.

2 Responses to We Can Do Better

  1. Rosana, read your July 6 blog this morning and tried to get an email address for you but couldn’t find on your blog, website or Google, so am leaving this reply. On one hand, your blog hit the Access Health CT/DSS outreach efforts and, on the other, indicated that no amount of outreach can force people into buying health insurance, even at subsidized cost.

    It’s interesting to note that, behind the scenes, DSS has qualified more than 4,300 of the parents for alternative HUSKY coverage over the past year. For those who don’t qualify for HUSKY, there are choices involving carriers and cost, even with a subsidized cost. Those decisions can be economically difficult, as you point out. What do you suggest, then? Absent returning parental eligibility to 201% of the federal poverty level with taxpayer dollars in this fiscal environment, which does not seem likely, we are collectively pulling out the stops to encourage parents who don’t qualify for HUSKY to consider a qualified health plan through Access Health CT.

    This isn’t the first time parental eligibility has been lowered in the 18-year life of the HUSKY program, but it is certainly the time with the most extensive customer outreach. If you have specific measures on how people who no longer qualify for HUSKY can be better encouraged to make the decision to purchase a qualified health plan, we would be interested in hearing more. Regards… David Dearborn, communications director, CT Department of Social Services (administering agency for Medicaid/HUSKY Health) David.Dearborn@ct.gov; 860-424-5024. (6/9/16)

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