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Voices Speaking

April 25, 2016

Governor’s Proposal Puts Low-Income Families at Risk for Losing Health Coverage

, , and Dumingu Aparna Gomes

This post was first published at the CT Mirror's CT Viewpoints website.

Connecticut has every reason to be proud of its long-term commitment to ensuring access to care for low-income children and families through the HUSKY program (Medicaid and Children’s Health Insurance Program).  We have one of the lowest rates of uninsured residents in the nation, thanks in large part to the State’s Medicaid program.  Long before enactment of the Affordable Care Act in 2010, Connecticut invested in the health of its children and their parents by aligning income eligibility for everyone in a family.  This policy was based on knowing that when whole families are insured, children’s access to care improves and parents stay healthy for work and family responsibilities.  Just last month, Connecticut’s  Governor Malloy, along with Connecticut’s budget director and state Medicaid administrators, extolled the quality improvements and cost savings realized through innovative changes to the HUSKY program.

Some of this progress will be undone if the Connecticut General Assembly goes along with the Governor’s April budget proposal to reduce income eligibility for almost 10,000 low-income parents. For example, in 2016 the income limit for a family of four would be lowered from $37,665 (155 percent of the federal poverty level (FPL) to $33,534 (138% FPL).   Because of federal Medicaid rules, the estimated savings associated with reducing coverage is just $900,000 in state fiscal year 2017.  This cutback in parent coverage follows a very significant change in eligibility just last year (from 201% FPL to 155% FPL), the full effects of which will not occur until this summer when up to 20,000 parents may lose HUSKY coverage.  Taken altogether, this proposal means almost 30,000 low-income parents could lose affordable health coverage over the course of this year and next. 

State officials have emphasized that affordable health care coverage is available for these parents through the health insurance marketplace, Access Health CT. However, even with federal subsidies for premiums and limits on out-of-pocket costs, coverage in a qualified health plan can be very costly for low-income families. For example, a family with two parents and two children earning $48,843 could be billed as much as $13,676 (28 percent of household income) for their health coverage.   In addition, dental health insurance for adults is a separate purchase, without premium subsidies and with significant out-of-pocket costs for limited coverage.

We now know what can happen when coverage is cut for low-income parents:  Last year, most parents were eligible for a one-year extension, putting off until July 31, 2016, the risk that they will lose coverage altogether.  Among those who actually lost coverage last summer (645 parents),  just one in four enrolled in a qualified health plan through Access Health CT, including some who experienced gaps in coverage.  Three of every four parents who were cut from HUSKY A last year are not currently enrolled through Access Health CT and may be uninsured

Missing from the data collected last year is whether eligible children were cut off inadvertently from the HUSKY program when their parents lost coverage, as happened in Maine and Wisconsin.  

Experience in other states suggests that the effect of the rollback of Medicaid eligibility can be reduced in part with policies that address the financial burden for families forced to pay for their own coverage.  For example, Connecticut could use state subsidies to help reduce the overall costs of marketplace coverage.  To date, we have not heard discussion of these or other proposals to mitigate the effect of this cutback on Connecticut’s families. 

Cutting income eligibility for parents—once again and before the full effects of last year’s cut are evident—is a huge step backward in Connecticut’s long-standing commitment to covering children and parents in low-income families. 

April 22, 2016

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Connecticut Voices for Children works to promote the wellbeing of all of Connecticut's children and their families by advocating for strategic public investments and wise public policies.

April 14, 2016

Ambitious Investments Will Boost Economy and Reduce Inequality

Rachel Leventhal-Weiner, Ph.D.

Last week, the Economic Policy Institute (EPI) released a report describing the high costs of child care in all 50 states, and the benefits of public investment in early childhood care and education. The authors of ‘It’s Time For An Ambitious National Investment in America’s Children’ propose an expansion of subsidies (known in Connecticut as Care 4 Kids) to allow parents access to affordable high quality child care, investments in high quality early education, and funding for before-and-after childbirth home visits – all of which will benefit children, families and the economy.

In their report, EPI finds that high quality child care is simply out of reach of many low- and middle income families. For example, in Connecticut, the annual cost for infant care is 6th highest in the nation at $13,880. This breaks down to $1,157 per month and is 37 percent more than in-state tuition at a four-year public college. Families with more than one child (an infant and a 4-year-old) would have to spend 29% of their income on childcare ($25,382 annually).

Annual Cost in Connecticut

Annual Cost Chart

Source: Economic Policy Institute: The Cost of Child Care in the United States

For too many families, the rising cost of childcare is prohibitive – particularly at a time of stagnating incomes. A full time minimum wage worker earning $19,968 annually would have to spend close to 70 percent of her annual income to afford high quality infant care for one child. Child care workers – low-wage workers themselves, earning on average just $21,840 yearly—would have to spent 63.6 percent of their annual earnings to put their own baby in infant care. Even for Connecticut families earning the median family income of $86,981, the cost of infant care amounts to 16 percent of household earnings, exceeding the recommendations of the US Department of Health and Human Services that child care costs should account for 10 percent or less of a family’s budget.

Expanding access to affordable care through subsidies and tax credits – such as the child and dependent care tax credit (CDCTC) – has enormous potential to improve the economic security of Connecticut families and the state’s economy. Among the findings:

  • Capping child care expenses at 10 percent of income would save the average Connecticut family with an infant $5,182 annually (it would save those with an infant and 4-year old $16,684 annually).
  • Decreasing child care costs by 1 percent would increase labor force participation by 0.2 percent, meaning more parents would be able to go back to work. The authors calculate that Connecticut’s gross state product (GSP) would increase by 1.2 percent or more than $3 billion annually.
  • Professionalization of the child care workforce would improve the economic well-being of providers and their families. Child care workers are disproportionately women and workers of color, meaning that higher wages among child care workers would help to close Connecticut’s gender-based wage-gap and vast racial pay gaps. By attracting and retaining a trained workforce, professionalization would in turn improve the quality of care.

Unfortunately, Connecticut, in response to structural budget challenges, is cutting investments in child care subsidy programs at a time when families can ill afford it; child poverty is at a record-high, low-wage work is replacing middle- to high-income work, and fewer families are being served by Care 4 Kids. The benefits to families and the state economy cannot be clearer. EPI is calling for an ambitious national investment in early childhood care and education, and we need the same here in Connecticut.


Issue Areas:
Early Care, Family Economic Security