Friday, May 29, 2009

Governor’s latest budget proposal includes cuts to health care

Governor Rell’s latest budget proposal includes cuts to health care programs including $50 million in FY 2010 and $52m in FY 2011 (6%) cuts to HMO capitation rates in HUSKY resulting from an audit of those rates by the Office of State Comptroller ($19m and $23m net savings to the state after accounting for the enhanced federal matching rate). She agrees to self-insurance for the state employee plan, but not until March, 2011. Consumers in the Charter Oak Health Plan would have to pay higher premiums under her proposal, varying from an additional $18.94/month for those under 150% of the federal poverty level (FPL) to $5.73/month for those between 235 and 300% of FPL. The FPL is currently $10,830 for a single person. She would also impose monthly premiums of $25/child up to $30 max/family on HUSKY Part B children between 185% and 235% of FPL. She also increases copays on all HUSKY Part B children. She agrees with the Appropriations Committee proposal to establish Special Needs Plans for consumers eligible for both Medicare and Medicaid (although she doesn’t believe this will save as much as Approp.s does). She assumes increased savings due to Medicaid fraud investigation. Her proposal also includes reducing Medicaid provider rates by 1%, hiring a company to manage services for the Aged, Blind and Disabled in Medicaid, implementing the SAGA waiver, requiring prior authorization for some dental care, eliminate eyeglass coverage for adults in Medicaid, a reduction in DSH funding to hospitals to cover the uninsured and Medicaid underpayments (net savings of $1m in each budget year), eliminates HUSKY outreach, and 10% cuts to Healthy Start programs. Her proposal also includes increased cost sharing for consumers the CT Home Care Program, reductions in nursing home administrative costs, and fewer homes will get rate increases. She also proposes cuts in non-entitlement block grant programs including elderly health screenings, teen pregnancy prevention, and support for community action agencies. To ensure CT receives the enhanced federal stimulus money, she adds back funding for HUSKY self-declaration of income and adult premiums. Her budget also cuts funding to community health centers, the needle exchange program, community services for people with AIDS, and the nursing and primary care loan repayment program. Overall her budget cuts $667m in FY 10 and $787m in FY 11. She is proposing these cuts in order to avoid tax increases.
Ellen Andrews

Thursday, May 28, 2009

New from Health Affairs –6.9 million more uninsured Americans by 2010, MA reform benefits continue, and cost does not equal quality in health care

Study predicts US uninsured to grow to 52 million by the end of next year

A study published today predicts that due to rising health care costs, by the end of 2010 another 6.9 million Americans will be uninsured, bringing the rate to 19.2%. For every 1% increase in health costs relative to income, another 314,000 Americans lose coverage. This model does not include the impact of unemployment, which is rising sharply, so the picture may be much worse. The authors note that previous estimates using this model of increases in the number of uninsured have, unfortunately, been largely accurate.

Study finds MA continues to enjoy benefits of health reform but challenges of costs and workforce remain

Another study published today finds that after health reforms implemented two years ago, MA consumers are getting more access to medical and dental care, preventive services and medications, particularly low income residents. However, emergency room visits have not declined, including those for non-emergencies. Just over 20% of adults reported difficulty getting care because a provider was not taking new patients (or patients with their condition); that rate was about much higher for low-income and patients with public coverage. Problems accessing care were worst in Western Mass. Initial gains in the affordability of coverage from reforms have eroded somewhat. The authors note that these changes occurred before the full impact of penalties in MA’s individual mandate occurred. The authors cite new measures enacted by MA to address cost control and workforce shortages.

Study finds health care quality and cost not linked, even divergent in some cases

A new study by Dartmouth researchers found that spending on health care does not guarantee quality at the level of individual hospitals, and could even be negatively correlated. The study looked at chronically ill Medicare patients’ care in the last two weeks of life across the US. Hospital averages for spending per end-of-life patient varied from $13,840 to $37,010. Earlier studies found that higher spending produces more care but not better care. This study confirmed that higher spending is associated with higher utilization – more hospital visits, longer stays, more specialists, and more tests -- but worse process-of-care performance. Prior research has found a similar lack of connection between spending and quality by region, but this is the first to show that there is no relationship at the hospital level and that there is wide variation within regions. The study has some important limitations – they only studied processes of care (i.e. appropriate antibiotics given for pneumonia), not outcomes (i.e. adult pneumonia death rates). They did not adjust for patient risk (i.e. some hospitals may treat sicker patients), but they chose process measures that should be done for every patient. By focusing on end of life, the study misses hospital successes – very sick patients who are treated and survive. However, the study does provide strong evidence that there are costs that can be wrung out of the health care system without endangering quality, possibly even improving it. The authors argue for better cost and quality reporting.
Ellen Andrews

Wednesday, May 27, 2009

WSJ blog highlights uninsured people forming small businesses to get health insurance

The Wall Street Journal reports today on a little-known option for coverage – forming a business and buying group coverage, even for groups as small as one person. Luckily CT is one of the states that allows small group coverage for groups of one and requires insurers to offer coverage to all small groups (guaranteed issue). They don’t require that it be affordable, but often small group rates are less expensive than individual policies. This is especially true for people with pre-existing conditions who may be rejected for coverage in the individual market. Small group rates in CT last year averaged $388/month for single coverage and $1,023 for families, 12% higher than the US average, according to a survey by America’s Health Insurance Plans. Small group applicants still have to give insurers their health information to determine pricing. Kaiser estimated that 29% of self-employed US workers were uninsured in 2005 and that rate was growing; small group coverage may offer a more affordable option for many.
Ellen Andrews

Tuesday, May 26, 2009

New Kaiser website tracks national health reform developments

Kaiser’s new Health Reform site helps track the sometimes confusing national health reform picture. It organizes resources from across their site including policy papers, polls, history and a calendar. My favorite feature allows you to compare the various versions being considered on key characteristics including an individual mandate, employer requirement and expansion of public programs. The site includes the new Republican plan, unveiled last week.
Ellen Andrews

Friday, May 22, 2009

Consumers share of health care costs to increase 7.4% next year

The 2009 Milliman Medical Index predicts that the typical cost of health care for a US family of four will rise to $16,771 on average. Milliman estimates that the total cost of coverage for a average household of four, even if there are no claims, will consume 8% of income. Workers will pay 41% of the costs of care, making the third year of increasing consumers’ share of costs. Rising costs of coverage is being driven by rising prices for treatment; for the first time, utilization of health care is expected to plateau this year. Over the last five years, the largest drivers of rising costs have been pharmacy and outpatient hospital prices. The study found wide variability in health costs in different cities. Milliman noted that unprecedented uncertainty in both the economy and the health care system has had mixed impact on costs. People who are unemployed and newly uninsured are reducing use of elective procedures, but those concerned that they may soon lose coverage are accelerating utilization.
Ellen Andrews

Thursday, May 21, 2009

SustiNet bill passes the House

The SustiNet bill, HB-6600, overwhelmingly passed the House last night 107 to 35. The bill creates a volunteer SustiNet Board of Directors to design and develop concrete steps to achieve health care reform including affordable coverage options for everyone, improving the health care delivery system, addressing chronic disease and significant prevention and wellness programs and report to the legislature by July 1, 2012. The Board includes a primary care physician, a nurse, a health policy expert or health economist, labor, a small business insurer, a health information technology expert and an actuary or insurance underwriter. The Board will be chaired by the Comptroller and the Health Care Advocate. The Board will make recommendations to the legislature to capitalize on national health care reform. The fiscal note did not identify any costs in the next two years. SustiNet is estimated to save $1.75 billion for individuals and businesses by 2014, averaging $875 per person.

Wednesday, May 20, 2009

NY medical home provides impressive, efficient care

Yesterday I visited the Queens-Long Island Medical Group office in Flushing, NY. The office is the first NCQA-accredited patient centered medical home in the US. Flushing is a colorful, bustling community; 70% of community residents are Asian. Despite the swine flu outbreak, the office was quiet and calm as it was on my first visit last month but extra providers had been brought in and doctors were seeing 30 patients each that day. I was there to take pictures for an upcoming CT Health Policy Project briefing next month on the medical home concept. The office looks just like any other medical practice, but it runs very differently than most. As the Chief Medical Affairs Officer described it, “everything swirls around the patient.” Patients go to exam rooms and all the services and providers they need come to them. Everything is organized for their visit the day before, making sure that test results are ready and any services they need are there for them; patients receive a reminder call the day before. Many tests can be done on site allowing decisions about treatment to be made during the visit, rather than having to contact the patient later. Providers work in teams of doctors, nurses and medical assistants. Everyone works at the top of their training and there is enormous respect across the staff. The office relies heavily on their electronic medical record system to ensure that anyone treating the patient has all the information they need and no one else does. Both a behavioral health specialist and dietician are on staff and the practice holds regular diabetes self-management groups. There is an enrollment center off the lobby to screen and enroll any patient eligible for public programs; appointments are not necessary. Regular patient satisfaction surveys show high ratings that have risen continuously since they began the medical home transition. The practice is also more efficient than before the transition, running on a well-organized team model. It’s a very impressive model; we all deserve a medical home.
Ellen Andrews

Monday, May 18, 2009

Dodd/DeLauro health reform event

Saturday Sen. Dodd and Rep. DeLauro hosted a well-attended town hall discussion on national health care reform at Griffin Hospital in Derby. Nancy-Ann DeParle, Director of the White House Office of Health Reform, was the invited speaker. It was good theater, but there was little concrete information about what they are considering, how it might work in CT, or really anything meaningful about policy plans. The event was interrupted by protestors advocating for a single-payer plan, however that sentiment and its relative, support for a public plan option, was spread across most in the room, including two of the only three physicians in this year’s Yale Medical School class considering family medicine. Many in the room wanted to hear some specifics about what is being considered behind closed doors, including individual and employer mandates, affordability standards, oversight, state vs. federal roles, that public plan option, insurance market reforms, and other critical design decisions that will determine if this program works in the real world. Unfortunately, the speakers offered little substantive information. Ms. DeParle did close by saying that she heard strong support for a public plan option, modeled on the traditional Medicare program.
Ellen Andrews

Friday, May 15, 2009

SustiNet Day at the Capitol

Wednesday was SustiNet Day at the Capitol, where hundreds of supporters gathered to show they are in favor of SustiNet and health care reform. Participants wore red t-shirts from the healthcare4every1 campaign with the campaign’s logo on the front and “SustiNet: Health Care We Can Count on” printed on the back. Participants sat in the gallery while the House of Representatives was in session or held signs spelling out “SustiNet HB 6600” in strategic locations (like by the escalator from the LOB to the Capitol).

I delivered cards signed by constituents in support of SustiNet to their Republican Senators, who were in caucus. While waiting for the Senators to come out of the caucus room, I met people who were new to the fight for universal health care. One woman had been uninsured for over ten years and finally got a job at Home Depot so she could get health insurance through them. Another young woman, a student from Massachusetts, is paying $2000 a month for individual coverage so it will cover her pre-existing condition. Since she isn’t a CT resident, she isn’t eligible for the high-risk pool. When she moves back to MA, she will be eligible for some sort of subsidy to bring her costs down significantly. When we were told that the Republican Senators had all left and were no longer in caucus, we delivered the cards to their offices in the LOB.

A rally was held on the north steps of the Capitol, where Juan Figueroa (President of the Universal Health Care Foundation), John Olson (President of the CT AFL-CIO), and the Reverend Shelley Copeland said a few words. This was followed by a silent march through the Capitol, which passed through the gallery of the House. I think we were definitely visible to legislators and others at the Capitol.
Jen Ramirez

Thursday, May 14, 2009

We need your feedback -- Opt in/out policy option for eHealthCT health information exchange

eHealth Connecticut, a nonprofit organization dedicated to encouraging the secure exchange of health information in our state, is working with DSS to implement a pilot health information exchange for Medicaid patients. As part of that pilot project, the CT Health Policy Project is working with eHealth Connecticut to develop a privacy and security policy for the health information exchange. eHealth Connecticut and the CT Health Policy Project are committed to incorporating the broadest range of public input possible into the policy’s development. We began with a consumer forum at the Capitol April 20th where we collected lots of helpful input. We are now considering a set of policy questions that need to be answered by any privacy policy. Please comment on this blog below or email with your thoughts, ideas or concerns.

Health information exchanges allow providers to work together by electronically connecting to coordinate patients’ care and reduce medical errors. In states with a health information exchange in place, a physician seeing a patient for an unresolved problem can review the workup performed at other physician offices, helping to reduce the burden of repeat testing on the patients and healthcare system. Providers in an ER can gain access to critical information about an unconscious patient through a health information exchange, improving the care they can provide.

The first question in developing the policy is whether to have an opt-in or opt-out policy. In an opt-in system, consumers must affirmatively choose to allow their health information to be shared in the health information exchange. In an opt-out policy, consumers are assumed to have agreed to share their information within current HIPAA guidelines unless they affirmatively choose to opt-out of the system.

The advantage of an opt-in system is that we can presume that every patient made an informed decision to participate. For instance, people who are positive for HIV or have mental health issues can be sure that their information will not be shared unless they agree. However, consumers generally agree to whatever their provider recommends and will usually sign whatever they are asked to at the time of treatment. We also cannot be sure that everyone fully understands their decision and its consequences. Another disadvantage with an opt-in system that requires consumers to fill out a form and mail it out after the point of service, is that, without significant efforts and resources (not available for this project), very few consumers follow through and send in their information even if they have no objection. If only a minority of patients participate in a health information exchange, it is unlikely to become a useful tool for providers, they are less likely to adopt and use the system, and it will not realize its potential to reduce medical errors and improve the quality of health care. Other questions include whether to include all records for Medicaid patients in the health information exchange from the beginning of the project, with or without patient consent allowing consumers to opt-out as they choose, or to begin filling the exchange with information only when patients access care.

Please give us your thoughts on an opt-in vs. and opt-out privacy policy for this project by commenting on this blog or emailing us at
Ellen Andrews

Last year drug costs rose for children, were down for seniors, and CT prescription use was below average

An annual report on drug costs and utilization by Medco, a pharmacy services company that covers over 60 million people, found that prescription drug costs rose by 3.3% in 2008 fueled mainly by price increases. For the first in ten years, utilization of prescriptions actually decreased (by 1.1%). Use of drugs by children grew by over 4% while use by seniors dropped by more than 1%. However spending on seniors averaged about $1700 per person compared to $200 for children. CT residents used fewer prescriptions per person than the US average, but not in the lowest category of states. Price increases were driven by the 8% rise in costs for brand name drugs, a rate that has climbed steadily over the last four years, compared to prices for generics which rose about 0.5%, a steady rate over time. Another contributor to rising costs was the approval of new high-cost drugs. The reduction in utilization of prescriptions was driven in part by the conversion of Zyrtec and Miralax to over-the-counter status. Use of generics and mail order delivery helped keep overall costs down. The authors expect costs to rise by 3 to 5% this year, 4 to 6% in 2010 and 5 to 7% in 2011. They expect an increase in specialty drugs, even higher inflations for brand name drugs, modest rises in treatment rates, and increased use of genomics to personalize therapies.
Ellen Andrews

Wednesday, May 13, 2009

White House reform chief coming to CT

Senator Dodd and Congresswoman DeLauro will host a visit from Nancy-Ann DeParle, Director of the White House Office of Health Reform. The visit, part of Sen. Dodd’s town hall meetings on health care, will be at 11:30 this Saturday morning, May 16th in the cafeteria at Griffin Hospital, 130 Division Street, Derby. Sen. Dodd is a senior member of the Health, Education, Labor and Pensions Committee, which is working on health care reform. The Senate Finance Committee, also working on reform, just released the options they are considering.

Tuesday, May 12, 2009

CT Overweight and Obesity forum

Join us at the Overweight and Obesity in CT forum this Thursday May 14th 8:30 to 11:30am at Wilde Auditorium, University of Hartford. The forum, hosted by the new Public Health Policy Institute of CT, will feature the Institute’s inaugural policy paper outlining the problem in CT, the impact of current policies and recommendations to improve our health. The researchers, Marissa Cloutier, Jeff Cohen, Meg Gaughan, Monica Jensen and Katherine Lewis, Executive Director of the Institute, will present their findings. Other speakers include DPH Commissioner Galvin, Rep. Betsy Ritter, Marlene Schwartz of Yale’s Rudd Center, Stephanie Rendulic, a nutritionist at DPH, and Walter Harrison, President of the University of Hartford. The project was funded by the Universal Health Care Foundation of CT. To RSVP contact Katharine Lewis at or (860)768-5464.

Monday, May 11, 2009

SutiNet bill modified

For budget and political reasons the SustiNet bill was changed last week. The new version creates a 14 member volunteer SustiNet Health Partnership Board of Directors across stakeholder groups tasked with making recommendations to the legislature by Jan. 1, 2011. The goals of SustiNet remain the same and much of the detail remained in the bill. The Board is to create committees on health information technology, medical homes, clinical care and safety guidelines and preventive care. The bill creates an independent information clearinghouse for the public on health plan options including SustiNet. The bill no longer outlines employer or employee responsibilities and does not include automatic enrollment. The bill creates task forces to address obesity, tobacco use and health care workforce shortages. Essentially, the bill creates a public volunteer entity to continue planning for universal health care and to allow CT to respond to federal health care opportunities as they arise. We expect more changes to the bill as it moves through the process. For the bill analysis, click here.
Ellen Andrews

Friday, May 8, 2009

Medicaid Managed Care Council/Charter Oak update

The news from today’s Council meeting is that while Charter Oak’s enrollment continues to increase – 8,210 as of May 1st -- the number of people denied coverage under the program is far higher -- 18,635 so far. While 705 of those were denied because they have coverage or have had it in the last six months, 16,672 are getting caught in the application process. The quick start application, which is short and is online, is only the beginning of the process. Applicants then get a follow up form requesting more information and that appears to be the problem. The Council should get a copy of that form at the next meeting. If consumers have not completed the entire process within 60 days, they must start all over again and re-apply from the beginning.
We also learned that to qualify for Charter Oak under the financial hardship exception to the six months uninsured rule, consumers must be spending over 33% of their income on health care. Members of the Council felt that this was an extremely high bar to set between consumers and affordable coverage. DSS noted that anyone who is paying between 25% and 32% of income on health care are held for a closer look by the Dept.; approximately 100 people are in that category now. DSS explained that the six month provision was meant to keep people from dropping private coverage, even if it’s more expensive, to come into Charter Oak. It is unclear what the state’s interest is in keeping people from benefitting from a more affordable coverage option if they are in the unsubsidized category.
On HUSKY, PCCM plans are moving forward and several questions were deferred to the upcoming PCCM Subcommittee meeting May 20th at 10:00am in Room 3800 of the LOB. We learned that from December 2007 to January 2009, while the health plans were not at financial risk and were not denying treatment, administrative costs were 13% for Anthem, 11% for CHN, 12% for Health Net and 14% for WellCare.
A lively exchange resulted from a presentation by the CT Health Foundation on their new reports outlining the potential impact of eliminating coverage for legal immigrants and implementing copays and premiums in HUSKY Part A. Pat Baker of the Foundation pointed out that research on imposing copays shows that both necessary and unnecessary services and drug use are reduced – that imposing copays on drugs that keep people well and out of the ER and hospital would be counterproductive. DSS argued that copays are used routinely in private plans and are necessary to keep the program within budget constraints. Members pointed out that this would be “penny wise and pound foolish” and that many private plans are moving to more sophisticated copay systems of reduced or eliminated costs on maintenance drugs, such as blood pressure regulators or asthma medications, that keep people well and out of more intense treatment.
Ellen Andrews

Thursday, May 7, 2009

Notes from community outreach

Yesterday I did an outreach event for about 25 participants in the STRIVE- New Haven program to let them know about different health insurance options. STRIVE does “employability skills training workshops” for residents of greater New Haven to help them find and keep jobs. STRIVE is a comprehensive job and life-training program with a great record of success.

The purpose of these outreach events is to go out into the community and to provide information and answer questions about health insurance coverage and where to find health insurance in Connecticut. Some of the health insurance options I talked about were individual insurance, employer-based insurance, COBRA, Charter Oak, HUSKY, SAGA, and free bed funds from hospitals. I was impressed by the STRIVE program as well as the professionalism of the participants, who demonstrated what they were learning in the program. They were interested in the different topics and asked questions to get more information (each person would stand and introduce themselves when they had a question). Participants asked questions about HUSKY, community health centers, and SAGA Medical (including spenddowns). All of the men wore ties with dress shirts and pants and the women wore clothes suitable for the workplace. I handed out a lot of our tip sheets, which are a great resource to provide more information about the topics I was covering. The audience was receptive and engaged; it was definitely a successful outreach event.
Jen Ramirez

Wednesday, May 6, 2009

New book for the book club

According to the Environment Protection Agency, a human life is worth $6.1 million. That estimate came out of cost-benefit analyses of arsenic from drinking water. Priceless, by Frank Ackerman and Lisa Heinzerling (2004), provides a fascinating look at the assumptions and questionable methodologies used to develop cost benefit analyses across fields. The costs of arsenic in drinking water, and resulting bladder cancer, was extrapolated from a survey conducted in a shopping mall in Greensboro, SC in the late 1980s asking shoppers how much they would be willing to pay to avoid chronic bronchitis. Apparently many cost benefit analyses are based on that same small survey of mall shoppers. How lives are valued in cost benefit analyses invite twisted ethical conclusions that would make most Americans cringe. A fascinating book that questions the ability of science to answer complex human questions.
For more books, go to the CTHPP Book Club.
Ellen Andrews

Tuesday, May 5, 2009

Legislative briefing on health care reform

A special briefing on health care, “Health Care Reform: Opportunities for New Directions”, was held yesterday at the Legislative Office Building in Hartford. Spectators almost filled the room. Speakers included Congressman Christopher Murphy, 5th District; Joy Johnson Wilson, Health Policy Director for the National Conference of State Legislators; and Enrique Martinez-Vidal, Vice President of State Coverage Initiative for the Robert Wood Johnson Foundation and Academy Health. The briefing was sponsored by the Annie E. Casey Foundation and the Universal Health Care Foundation of Connecticut.

Congressman Murphy thinks there are excellent prospects for reform at the federal level because of the economy, the desire of the American people, and a President who has made health care reform a priority. The downturn in the economy has led more people to see health care reform as urgent, especially as more people are losing their jobs and their employer-sponsored health coverage along with them. Because their constituents see reform as important, this is reflected in Congress. There are different types of health reform plans at the federal level, including single payer, making it easier for groups to combine for the purposes of providing health care, and some type of mandate (either individual or employer).

According to Congressman Murphy, a public plan, which would compete in the private market, would test out a single payer system on a smaller scale. He also said that the work on health care reform that is being done in states like Connecticut is pushing the federal government to take action. When asked about the timetable for reform, Mr. Murphy stated that they are hoping for something by the end of the summer. But to use the reconciliation process, Congress won’t be able to vote until October 15, 2009.

Ms. Johnson Wilson spoke about challenges and opportunities for states, some of which are overlapping. The economy presents a challenge because of limited funding and all of the other problems that come with a recession but an opportunity because it forces us to concentrate on the problem of health care reform and reduce inefficiencies. The American Recovery and Reinvestment Act (ARRA) of 2009 has placed more restrictions on funding than did previous federal economic assistance to states.

On the federal level, some areas of consensus are: the expansion of Medicaid, improving quality, expanded use of health information technology, refocusing on primary care and preventive health, and increasing transparency and accountability. Some of the areas on which there is disagreement are: a public plan option, individual or employer mandates, and changing the tax treatment of health care premiums in the employer-based system. According to Ms. Johnson Wilson, draft bills for health care reform will be available in the next 2-3 weeks. The goal is for the bills to be reviewed on the floor before the recess in August. Congress will have to find offsets for some of the spending on health care.

Enrique Martinez-Vidal gave some examples of insurance market reforms that states are working on, including extending coverage for dependants past the age of 18, eliminating pre-existing condition exclusions when someone is going from one insurance policy to another (including the individual market), and merging the small group and individual markets. Some of the cost containment and quality improvement goals for the states are: an emphasis on preventive care and primary care, care management for chronic illness, health information technology, and value-based purchasing.
Jen Ramirez

Monday, May 4, 2009

May CT Health Policy Web Quiz

Test your knowledge of CT hospital finances, take the May CT Health Policy Web Quiz. This month’s quiz was written by Karen Nepomuceno, Policy Intern at the CT Health Policy Project.

Friday, May 1, 2009

Health care reform briefing for legislators

Monday there will be a special briefing for legislators, open to the public, on Health Care in 2009: Challenge and Opportunity. Speakers include Sen. Chris Dodd, Congressman Chris Murphy, Enrique Martinez-Vidal of Academy Health’s State Coverage Initiative, and Joy Johnson Wilson from the National Council of State Legislatures. The briefing will be in Room 2C of the LOB from 10am to noon on Monday May 4th. The briefing is sponsored by the Universal Health Care Foundation of CT and the Annie E. Casey Foundation.

New briefs on impact of HUSKY cuts

Two new briefs were presented yesterday at a legislative briefing by the CT Health Foundation.
Speakers included Jack Hoadley from Georgetown University to describe his research on cost sharing for HUSKY families and cutting coverage for immigrants, and Evelyn Richardson, a mother from Hartford, to discuss the impact of HUSKY cuts on her family. Adults and children in HUSKY make up 23% of Medicaid costs but are only 23% of the population. Under the new federal stimulus funding, CT is reimbursed over 60% for those costs. In response to the growing state budget deficit, the Governor has proposed new premiums and copays for HUSKY families and eliminating completely coverage for legal immigrants. Premiums would impact 18,000 HUSKY parents and it is estimated that 8,000 of them could no longer afford coverage and would become uninsured. CT would also risk losing $1.3 billion in desperately needed new federal funding by imposing premiums which would only save the state $21 million. New copays on services would likely reduce utilization of critical services and drugs, causing increases in ER visits and hospitalizations. Providers responsible for collecting these copays may decide to stop participating in HUSKY. CT now pays with all state dollars to cover 6,000 legal immigrants. New federal law allows the state to collect federal funding for 2.500 of those immigrant children and pregnant women replacing $10 million of the estimated $50 million cost of the program. Studies estimated that every dollar cut from prenatal care costs $3.33 in extra postnatal care and $4.63 in other childhood services.
Evelyn Richardson described caring for her family working three jobs, one full time and two part time, and still struggling to make ends meet. Despite working many hours for three employers, she has needed Medicaid coverage for her family for over twenty years. Her children suffer from asthma, nut allergies, and eczema. She needs three sets of emergency medications for her children – one at home, one at school and one at child care. That would involve paying three times the copays. She said between rent, food and keeping the gas and lights on she would have great difficulty finding extra money for premiums and copays under the Governor’s proposal.
Ellen Andrews