By Ken Dixon
HARTFORD — Connecticut, determined to take full advantage of President Barack Obama’s now-affirmed Affordable Care Act, ultimately expects to add about 150,000 people to its low-income Medicaid program, officials say.
The state already is about halfway to that figure. Some 70,000 low-income adults age 19 to 65 have recently been added to Medicaid, which is financed equally by the federal and state governments.
Beginning in 2014, when the state’s Health Insurance Exchange is up and running, the federal government will pick up all of the costs of the expanded coverage.
“It’s the right thing to do,” said state Healthcare Advocate Victoria Veltri.
Some states have balked at expanding Medicaid eligibility out of fear that larger enrollments would become budget-busters, noting that some of the federal support for expanded coverage will be phased out. For instance, Louisiana Gov. Bobby Jindal, a Republican, said Thursday his state won’t participate in the new health care insurance program. Louisiana has no plans to expand its Medicaid coverage, either.
In contrast, Connecticut is months or even years ahead in setting up its health exchange.
Democratic Gov. Dannel P. Malloy says in the long run, 500,000 state residents currently without health coverage will get it under the ACA through a variety of programs.
“Contrary to what some of my friends on the other side of the aisle are saying, this is in fact about cost containment and about making wise investments to do that over the long haul,” Malloy told reporters Friday.
The current Medicaid eligibility guideline is 56 percent of the poverty level, but in January 2014, it will rise to 133 percent of poverty incomes.
“We have a significant portion of our state that is at or below that income level and they won’t be able to afford a plan without Medicaid,” Veltri said in a phone interview.
Other current state programs include Husky insurance for 275,000 children and 134,000 parents and pregnant women. In all, 712,000 state residents are enrolled in Medicaid programs, according to federal statistics.
About $1.5 billion in additional federal funding is anticipated for Medicaid recipients in Connecticut, as well as insurance subsidies for those who don’t meet poverty guidelines.
Benjamin Barnes, secretary of the state Office of Policy and Management, said that by around 2019, 100 percent federal funding will fall to 90 percent. But he said the state should be realizing major cost savings in other areas, such as so-called uncompensated care in emergency rooms, where many poor people get free treatment later paid for by those with insurance.
“Starting in 2014, state revenue will increase dramatically and will more than cover the costs we pick up,” Barnes said.
“The bottom line is that the benefits of having many fewer uninsured individuals means insurance will be more affordable, providing the federal government honors its commitments under the ACA,” Barnes said in a phone interview.
The state’s latest ACA request to the federal government is for $107 million to continue the start-up of the Health Exchange.
“We had planned all along to follow the law of the ACA,” said Veltri, the state advocate. “We were running our own exchange. I think we were very far ahead. There might be one or two states ahead of us, but we have been in that very top tier of states that have embraced the exchange. We will be ready, and maybe some other states will not.”
Veltri said when the exchange is operational, residents will be able to assess their income levels and determine whether they are eligible for Medicaid coverage. Those with higher incomes will be given an array of other insurance options.
“It’ll be a one-stop shop,” she said. “They will come in, then someone will determine whether they’re Medicaid eligible. If not, they can see if they can enroll in a plan. There may be different tactics, but the one over-arching strategy is to reach out to the uninsured and to reach small business too.”