About 1,200 Medicaid Recipients Switching to State Health Insurance Exhange Due to Change in Eligibility Requirements

About 1,200 Medicaid recipients in Connecticut will have to find insurance coverage through the state's health insurance exchange starting Sept. 1 as the state changes eligibility requirements in an effort to balance its books.

The state's new two-year, $40.3 billion budget, which took effect July 1, reduced the income levels needed for certain people to qualify for Medicaid. About 18,000 more are scheduled to be transitioned to private health insurance plans offered through Access Health CT, on Aug. 1, 2016, according to the state's Department of Social Services.

Advocates said they want to make sure families know how to handle the change. Groups ranging from community health centers to legal services organizations are ramping up to answer recipients' questions once DSS begins notifying people by mail in the coming days about how to get coverage through Access Health CT.

"First of all, it's very confusing," said Deb Polun, director of government affairs and media relations at the Community Health Center Association of Connecticut. "We still feel like people will be thrown off guard."

It is one of the first eligibility changes to Connecticut's Medicaid program since the state increased the rolls in 2010 by expanding income eligibility. However, DSS said the change does not affect the expansion group, which included low-income adults without dependent children.

Enrollment under the Affordable Care Act has surged beyond expectations in some states, raising concerns about costs straining budgets. At least seven states have increased their cost estimates for 2017, according to an Associated Press analysis.

In Connecticut, the new, tougher eligibility requirements impact parents and relative caregivers of children enrolled in the HUSKY program. The state's eligibility threshold is dropping from 201 percent of the federal poverty level to 155 percent of the federal poverty level, or under $24,692 for a family of two and under $37,586 for a family of four.

The first group of 1,200 parents and caregivers includes people who do not have earned income. Rather, they receive unearned income from sources such as unemployment and child support.

The second group of 18,000 individuals, whose Medicaid coverage ends next year, includes parents and relative caregivers with earned income. Under federal rules, only they are eligible for the yearlong extension of so-called transitional medical assistance, which will be the same Medicaid coverage.

Vicki Veltri, the state's health care advocate, said recipients who receive the notice from DSS should check to see if they might still be eligible for Medicaid, especially if their income has changed or their family size has changed.
In the meantime, Veltri said she believes Access Health CT is making sure it will have the staff needed to help people transition into the appropriate private insurance plans, which will likely be subsidized.

"There's no question, it's going to take a ton of education for people. I think we've always known that," she said. "It's on the exchange. It's on DSS. It's on all of us to make sure we're doing everything we can to educate people."