Connecticut residents' health coverage OK for 2017, but future uncertain

Don’t panic — yet.

That’s essentially the message from the head of Access Health CT, the state’s online health insurance marketplace, to the 319,011 state residents now covered by Medicaid or private insurance plans purchased through the site. Actions in Washington last week won’t cause any immediate change.

“The carriers are committed to being on our exchange through the end of 2017,” James Wadleigh, chief executive officer of Access Health CT, said Wednesday.

While customers' insurance coverage is assured through the end of the year, 2018 is an open question. ConnectiCare and Anthem Blue Cross and Blue Shield, the two companies offering plans on Access Health CT, have until June 30 to tell the state whether they’ll continue next year.

Last week, ConnectiCare, citing the actions in Congress toward repealing the Affordable Care Act that paved the way for the state’s establishment of Access Health CT in 2014, sent a warning letter to the exchange. The letter notified Access Health CT that because of the “financial risk” to the company if the repeal continues to advance, it will be forced to withdraw in 2018.

“We are hopeful that we are able to withdraw this notice in the coming months and remain an active participant on the exchange,” wrote Eric Galvin, president of ConnectiCare.

The repeal measure that narrowly passed the House of Representatives on Thursday and now heads to the Senate would be “catastrophic” for more than a half million Connecticut residents, those insured both through the exchange and on the private market, said Democratic Lt. Gov. Nancy Wyman. She is chairwoman of the board for Access Health CT, a quasi-public agency. The Republican plan would phase out coverage for more than 200,000 state residents covered by the expansion of Medicaid under the ACA, and replace the requirement that people with pre-existing health conditions not be penalized with exorbitant rates for insurance, among other changes.

“Trumpcare further destabilizes the health care marketplace,” she said.

State Comptroller Kevin Lembo, who formerly was the state healthcare advocate, is also warning of dire consequences for state residents if the current plan wins Senate approval and a signature from President Trump. He invited residents to sign a petition on his website to oppose passage of the legislation.

“We could face a future where millions lose their insurance, people with pre-existing conditions once again can’t get coverage, Medicaid funding is gutted and premiums skyrocket for older Americans,” he said. “To make matters even worse, all of this is paid for by giving the wealthiest Americans a tax break.”

In response to the actions in Washington, Wyman said she is convening a bipartisan health strategy working group. The group will look for a way to continue Access Health CT even if the ACA is ultimately repealed. But the current GOP plan’s elimination of federal subsidies that offset premium costs on the exchange and federal support to the state for expanded Medicaid, however, make that a daunting challenge.

“We’re looking at what we can do to try to keep things going,” she said.

Wadleigh, the CEO of Access Health CT, said the experience of the ACA in Connecticut has been positive, with the state’s uninsured rate dropping to 3.8 percent, from 8 percent before the marketplace existed. After three years of increasing enrollments, the numbers slipped for the 2017 signups, in part a result, he believes, of the uncertainties about its future. Fewer choices and rising costs have also had an effect. When the site started, there were four carriers offering plans. Now there are just two.

About 2.7 percent fewer people signed up through the exchange for 2017 compared to last year, said Kathleen Tallarita, spokeswoman for Access Health CT. Currently, 100,303 people have private insurance plans through the exchange, and 219,000 have Medicaid through the site.

Of those who enrolled in private plans, 75 percent are receiving federal subsidies and saw their premiums increase an average of $5 to $10 per month compared to last year, Wadleigh said. The 25 percent of customers not receiving subsidies saw their premiums jump an average of $75 per month.

While the current debate about the future of the ACA is focusing on health insurance costs, Wadleigh believes more attention must be paid to the high cost of health care. Health insurance won’t become more affordable and accessible, he said, until prices for medical care come down.

“Health care is expensive across the country,” he said. “Hospitals are expensive. Doctors are expensive. Medical devices are expensive. We can’t continue not to discuss what’s driving costs in health care.”

Editor's Note: This version corrects the title of state Comptroller Kevin Lembo.

Access Health CT 2017 Numbers:

  • Private insurance customers: 100,303

  • Medicaid customers: 218,707

  • Average monthly premium for private insurance: $570

  • Average monthly federal subsidy for private insurance customers: $420

  • Average deductible for private insurance: $4,000

  • Maximum income to qualify for subsidy: $97,200 for a family of four

  • Maximum income to qualify for Medicaid: $48,843 for family of four

  • Penalty for not having insurance: $695

  • Number of state residents paying penalty: not released by the IRS 


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