Sunday, April 11, 2010

Medicaid Managed Care Council update



Friday’s Council meeting was relatively uneventful. We started with a wonderful outreach video by CT’s Healthy Start programs describing the important work they do supporting at-risk pregnant women and connecting them to the care they need to ensure healthy births. (Advocates think it would be a good idea to start every Council meeting with babies – it makes it hard to be grumpy.) We then heard about the challenges of keeping families enrolled in HUSKY. A study by CT Voices for Children found that 141,000 people came into HUSKY in 2006 and 2007, but total enrollment grew by only 11,000. However they were unable to determine if people left because they found other coverage or if they became uninsured. DSS noted that they have implemented several improvements to the eligibility system since 2007. PCCM/HSUKY Primary Care enrollment is up to 359 clients and 237 providers. DSS has also agreed with advocates’ concerns and will ask CMS for permission to delay the PCCM evaluation until 2011 when it is hoped enrollment will be high enough to make the study meaningful. DSS described their plans to move all SAGA recipients into Medicaid (as of April 1st) under a new option passed in the recent national health reform act. It is expected that the option will save CT $53 million over the next 15 months. CT is the first in the nation to apply under this provision. However we are eligible because the state never acted on multiple directives from the General Assembly to apply for a waiver to cover SAGA – most other New England states have been covering childless adults under a Medicaid waiver for years. New enrollment numbers from ACS show that about half of all Charter Oak members are over age 50 and that older members have higher incomes than younger members – over half of members paying the full, unsubsidized Charter Oak premium are over age 50.
Ellen Andrews