Connecticut officials on Monday warned that Medicaid cuts outlined in a Congressional Republican plan would have devastating consequences, even though the changes stop short of the scenarios that would have most heavily impacted enrollee benefits and the state budget.
In a plan released on Sunday, House Republicans on the Energy and Commerce Committee provided details for the first time on how they propose to find $880 billion in spending cuts in order to meet the Trump administration’s budget priorities. Among other measures, the plan would implement 80 hours of work, volunteer or educational requirements a month for certain enrollees and freeze the hospital tax, a mechanism that enables states to increase the amount of Medicaid funding they receive from the federal government.
“This bill has a number of provisions that seem designed to hurt people in Connecticut, that seem designed to take coverage away from folks, to put our hospitals into financial difficulty,” Sen. Matt Lesser, D-Middletown, co-chair of the state legislature’s Human Services Committee, said during a press conference at the state Capitol on Monday.
Rob Blanchard, a spokesperson for Gov. Ned Lamont, said that the state is evaluating the impact of the proposal on residents and the state budget, but “it’s clear that these proposed cuts will have a significant impact on every state.”
“In the meantime, the Governor will continue working with DSS, our legislative leaders, and our Congressional delegation to mitigate any damage from potential cuts and preserve access to quality care for the most vulnerable residents in our state,” Blanchard wrote in emailed comments.
Some of the most drastic changes to the program floated over the last several months, including reduced federal matching and a per enrollee cap on federal funding, are not included in the plan. Lesser said the absence of those proposals is a sign that “there’s really been an impact from this public outcry” that’s taken place over the last several months.
“Republican members of Congress are hearing from their constituents when they hold town halls. They’re being reminded that Medicaid is a program that people in red states and blue states rely on,” Lesser said.
Medicaid, known as HUSKY in Connecticut, covers roughly 1 million people in the state, according to the Department of Social Services, which equals just about 25% of the population.
States depend heavily on the federal government to pay for the program. The state’s Office of Policy and Management projects Connecticut will spend a total of $11.6 billion on Medicaid this fiscal year. The federal government contributed roughly $6.9 billion, or 59%, of that funding.
The state is in the process of analyzing how Medicaid work requirements would impact the state budget, Christine Stuart, a spokesperson with the Department of Social Services, confirmed.
State officials in the past have criticized work requirements for being expensive to implement and based on incorrect assumptions that Medicaid enrollees don’t work. Although they are more moderate than some of the other changes Democrats feared, Pareesa Charmchi Goodwin, executive director of the state legislature’s Commission on Racial Equity in Public Health, said bureaucracy will likely lead to loss of coverage, even for those who qualify.
“It is a lot of additional layers of administration and bureaucracy that are very difficult for people to navigate, and people end up losing benefits even if, for example, they are working,” Charmchi Goodwin said on Monday at the Capitol. “It’s deeply, deeply concerning.”
The Connecticut Hospital Association called the proposal, including the plan to freeze hospital taxes, “an attack on states and the way state budgets are developed to fund Medicaid.”
“If federal contributions to state Medicaid programs are frozen, over time healthcare providers will have no choice but to make up the significant losses elsewhere or cut back on services. This would be devastating to affordability and access,” Paul Kidwell, senior vice president of policy at CHA, stated in emailed comments.
The proposal would also implement copays for certain Medicaid enrollees, require eligibility screening every six months instead of every year and penalize states, like Connecticut, that provide Medicaid-like coverage to children and people who are pregnant or postpartum regardless of immigration status.
Connecticut provides Medicaid-like state-sponsored coverage regardless of immigration status to children 15 and under, as well as people who are pregnant or postpartum, who have qualifying incomes.
The federal government covers roughly half the cost of coverage for traditional Medicaid enrollees, but for those who don’t qualify for Medicaid because of their immigration status, the state bears 100% of the costs. However, the feds provide 65% of the funding for prenatal coverage, even for those who wouldn’t qualify because of immigration status.
Lesser called the attempt to prohibit states like Connecticut from providing coverage regardless of immigration status a “huge overreach,” particularly considering they do so without the support of federal funding. He predicted the measure would face legal challenges.
Additionally, the plan seeks to ban Medicaid coverage of gender-affirming care for transgender kids and prevent providers who perform abortions from receiving Medicaid funding for any services they provide. Federal law already prohibits federal funding for abortions, except in cases of rape, incest or life endangerment of the pregnant person.
Amanda Skinner, president and CEO of Planned Parenthood of Southern New England, said the provision would leave “thousands of patients in Connecticut with nowhere else to turn.”
“In Connecticut, 46% of PPSNE’s patients rely on HUSKY Health to receive services like birth control, cancer screenings, wellness exams, STI testing and treatment, and more. We are their trusted source of care. Our health centers are an irreplaceable part of Connecticut’s health care system,” Skinner wrote in emailed comments.
Lesser conceded that the proposal includes a limited number of measures he sees as beneficial to residents, including provisions to rein in the power of pharmacy benefit managers, companies that serve as middlemen to help manage drug benefits for health plans, but have recently come under fire for driving up prescription drug costs.
Congressional Republicans are trying to finish up the reconciliation process and get the package to President Trump later this summer.
This story was originally published by the Connecticut Mirror.
