CT Medicaid wins in health reform reconciliation bill

The reconciliation bill scheduled to be considered this weekend by Congress benefits CT’s Medicaid program, and the state bottom line, in significant ways.

The bill would expand Medicaid coverage to all state residents (except undocumented immigrants) up to 133% of the federal poverty level (FPL) -- $14,620.50 for individuals and $19,669.50 for a family of two – in 2014. CT would receive full funding for all newly eligible residents in 2014, tapering down to 90% after 2019. In 2007/2008 CT had 110,200 uninsured residents living below 133% FPL. In January of this year there were 43,549 members of our state-funded SAGA program; those members would become eligible for Medicaid and, because we do not have a waiver to cover them, they should be eligible for federal funding saving the state $133 million. Because CT does not have a Medicaid SAGA waiver, coverage of SAGA members would qualify for federal funding under the reform bill (sometimes it pays to procrastinate). It is also likely that many of the 6,077 Charter Oak residents in the lowest income band (0 to 150% FPL) as of March 1st will become eligible for Medicaid and full federal funding, saving the state what we spend on their subsidies.

Medicaid primary care providers will benefit under the reconciliation bill which increases their rates to Medicare levels in 2013. In 2008, CT primary care Medicaid rates averaged 0.78 of Medicare levels, according to the Kaiser Family Foundation. The incremental cost will be paid fully by the federal government from 2013 through 2014. In 2008, CT’s rates were better than most other states (weighted average of 1.44 compared to other state’s rates). CT would receive more if our provider rates were closer to the national average, but we will be getting more than we did in the past.

In January, the CT Health Policy Project outlined a list of questions CT’s Medicaid program needs to answer in implementing national health reform.
Ellen Andrews