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Health official sounds alarm over costs

A proposal to shift thousands of residents covered by Connecticut’s HUSKY Medicaid program to private health plans marketed through a statewide exchange could have a damaging effect on many low earners, state Healthcare Advocate Victoria Veltri warned.

The Office of the Healthcare Advocate — the state’s federally designated Consumer Assistance Program under the Affordable Care Act — will partner with the Connecticut Health Insurance Exchange to educate and enroll individuals in private health plans that will be sold on the exchange, officials announced earlier this month.

Veltri warned that changes proposed within Gov. Dannel P. Malloy’s budget could make it difficult for many of the state’s low-income residents to afford coverage under the plans that will be marketed through the insurance exchange beginning in October.

“For consumers, especially for those with very low incomes, next year is going to be a very tough year for them,” Veltri said. “We need to do whatever we can to make health care accessible to them. And that’s an uphill climb right now.”

Residents with minor children who earn up to 185 percent of the federal poverty level are currently eligible for free health coverage through Connecticut’s HUSKY Medicaid program.

While the Affordable Care Act (ACA) requires states to provide Medicaid coverage to all legal residents earning up to 133 percent of the poverty level, Malloy’s budget proposal would end coverage for thousands of residents earning between 133 percent and 185 percent of the poverty mark.

Under the ACA, low earners will be eligible for federal subsidies to offset the cost of private coverage.

Kevin Counihan, CEO of the state’s insurance exchange, acknowledged that many people who had previously been eligible for free health care coverage would be faced with out-of-pocket costs under the Malloy plan.

The tradeoff, he said, is that the residents impacted would likely have a much easier time getting coverage, with just 31 percent of the state’s primary care physicians accepting Medicaid patients.

“States are experiencing such a huge increase in Medicaid enrollment because of the recession — and the economy hasn’t bounced back. It’s been a huge strain on state budgets,” Counihan said, noting that Connecticut is not the only state considering a rollback of its Medicaid programs.

“The subsidies are meant to be a clear form of help for those people,” he said. “The other side is, quite frankly, that people in commercial products, such as those above 133 percent, are going to have a much easier time getting coverage.”

In order to keep health insurance cost increases down, Veltri said it’s important that hospitals and health care providers share in the burden.

“The bottom line to me is, whatever we can do to make health care more affordable, we need to do it,” Veltri said. “Not just because people need to enroll in the exchange, but because we need to have a sustainable economy.”

She called for greater transparency with regard to the costs incurred by providers to deliver care.

“We have been in the dark for the most part on the costs and the prices – there’s a substantial lack of transparency there,” she said. “If you want to drive down health care costs, you have to be aware of what those costs are.”

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Patrick Gallagher

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