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Voices Speaking

March 19, 2019

Voices from the Capitol: Access to Health Care, Recent Successes

Improving Access to Health Care

The Connecticut General Assembly is well into the legislative session, and while public hearings continue, most legislative committees have passed their deadlines to introduce new bills. This week, Karen Siegel, Health Policy Fellow at Connecticut Voices, will submit testimony on health-related bills before the Human Services Committee, including the following proposals:

  • Expanding health coverage through a public option. House Bill 7339, An Act Concerning a Public Health Insurance Option, would establish a working group to make recommendations about the establishment of a public health insurance coverage option that would be funded by enrollee premiums and open to individuals ineligible for Medicaid. In our testimony, we make recommendations to amend the proposal to address who will benefit from public option and how it will be structured. Earlier this month, we testified about House Bill 7267, another public option bill.
  • Expanding Medicaid and HUSKY B coverage for children. We support Senate Bill 1053, which would cover all uninsured, income-eligible children, regardless of their immigration status. An estimated 17,000 of Connecticut’s uninsured children are undocumented.
  • Promoting two-generational family economic success. We support Senate Bill 1080, which would create a Two-Generational Family Economic Success Cabinet within the executive branch. The cabinet would facilitate interagency collaboration to support moving families towards economic security, workforce preparedness, and improved health, while promoting dignity and independence.
  • Expanding access to providers for pregnant Medicaid members. We will testify in support of Senate Bill 1078, which would provide state certification of doulas and Medicaid reimbursement for their services. It would also study the effects of doula services on health outcomes for pregnant Medicaid beneficiaries and their infants. Doulas provide physical, emotional, and informational support before, during and after the birth; they do not provide medical care. Evidence suggests that doula support is likely to reduce the dramatic racial disparities in maternal and infant health outcomes. These disparities are tied to social as well as medical factors. Access to doula care through Medicaid may help to ensure that low-income women of color have the support and advocacy they need before, during, and after childbirth.

Recent Successes

In the last week, legislative committees approved bills that are supported by Connecticut Voices:

  • The Labor Committee took an important step toward ensuring that parents who work full-time can make ends meet by approving legislation to increase state state’s minimum wage to $15. The Committee voted in favor of Senate Bill 2 and House Bill 5004, both of which were supported by Connecticut Voices.
  • The Committee on Children passed Senate Bill 452, which would establish a State Oversight Council on Children and Families. The Council provides a structure for various stakeholders to support the needs of children and families who could be at risk of entering the foster care system. As we described in our testimony, the Council could help the state to maintain and build upon important gains made under the Juan F. Consent Decree, even after we have exited from federal oversight.

Additional Recent Testimony

Connecticut Voices staff also submitted testimony on the following bills over the last week:

You can always find all of our legislative testimony on our website. 

Issue Areas:
Budget and Tax, Child Welfare, Education, Family Economic Security, Health
March 14, 2019

Voices from the Capitol: Legislative Highlights, Educational Disparity Data

March 14, 2019

Highlights of Our Work at the Capitol

The General Assembly continues to hold hearings in several key committees. Connecticut Voices for Children testified recently on a variety of bills affecting children and families. These are some highlights:

  • Speaking up for low wage working families. Jamie Mills testified in support of Senate Bill 2 and House Bill 5004, which would raise the state's minimum wage to $15. As Jamie explained in her testimony and in an op-ed published recently, we need to both pay workers a living wage and adjust our system of public supports to ensure that improved wages do not result in the loss of resources such as Medicaid and child care subsidies.
  • Protecting public investments in children and families. Subcommittees of the General Assembly's Appropriations Committee held public hearings on the Governor's budget proposal. Our staff submitted testimony on elements of his budget plan that affect children and families served by health programs, the Department of Children and Families, the Judicial Branch, and the State Department of Education and Office of Early Childhood.
  • Calling for equitable and expanded educational opportunities. Wendy Waithe Simmons testified on several bills that would bring us closer to establishing equitable education opportunities. These include bills that would expand eligibility for Care 4 Kids child care subsidies and improve on low compensation for early care and education providers. For more information on how we can improve access to Care 4 Kids, see our fact sheet.
  • Protecting youth in foster care. Jessica Nelson testified in support of House Bill 6403, "An Act Concerning a Children in Care Bill of Rights and Expectations and the Sibling Bill of Rights." This legislation directly addresses concerns expressed by youth in foster care about opportunities to connect to their schools and communities and express their identities. The bill was approved by the Committee on Children. For more information, see our fact sheet.
  • Ensuring age-appropriate treatment of court-involved youth. Adult courts are not equipped to provide children with therapeutic, developmentally-informed services to help them become productive adults, and Black and Brown children are disproportionately more likely to be transferred to adult prison than their white peers. Lauren Ruth testified in opposition to House Bill 7332, which would loosen the statutes defining when the court may choose to transfer youth from juvenile court to adult court.

Also, this Friday, March 15, the Finance, Revenue, and Bonding Committee will hold a public hearing on Senate Bill 877, which would implement the Governor's revenue proposals. We will submit testimony on this legislation and will oppose House Bill 6031, which would phase out the estate tax.

Thank You for Signing On to Protect Access to Educational Disparity Data!

Connecticut Voices would like to express our gratitude to the 39 organizations and 81 individuals who signed onto our letter to the Education Committee calling on its members to oppose Senate Bill 851! Your support can help us to preserve access to vital data that enable us to measure and reduce racial and ethnic disparities in education among our state's children and youth. This legislation, which could come up for a committee vote soon, would limit the ability to examine education data by student ethnicity, making it difficult to detect ethnic disparities in access to high-quality education or to measure the impact of reforms on specific student populations. To learn more, see our sign-on letter, fact sheet, and testimony.

Our Latest State Budget Reports

If you missed them, be sure to download our latest reports on the state budget:

  • Impact of the Governor's FY 2020-2021 Budget on Children and Families. Governor Lamont's proposed state budget avoids additional major cuts to essential programs and services for children and families, though it is based on revenue proposals that fall most heavily on our lowest income taxpayers. It asks little of our highest income taxpayers.
    Download the report
  • Connecticut's Radical New Budget Rules: Locking in Decreased Investment in our State for the Next Decade. Connecticut's rigid fiscal rules will ensure that Connecticut remains in a permanent state of fiscal deprivation, starving our schools, health systems and infrastructure of crucial investments.
    Download the report and fact sheet

Additional Recent Testimony

In addition to the legislative testimony described above, we delivered the following testimony on bills in recent weeks:

You can always find all of our legislative testimony on our website.

Issue Areas:
Budget and Tax, Child Welfare, Early Care, Education, Family Economic Security, Health, Juvenile Justice
January 24, 2019

The Impact of the Federal Shutdown on Children

In December, we wrote about the passage of the Farm Bill, including funding for SNAP. Unfortunately, the shutdown of the federal government poses a new threat to families’ access to nutritional assistance. The Department of Agriculture (USDA) is working with states to keep SNAP operating through February. This strategy includes early distribution of benefits, which families will have to make last through the end of February. The plan for distributing SNAP going forward is unclear and even if the shutdown ends, some families may experience a long gap between distributions. Some retailers may be unable to accept SNAP benefits due to unprocessed renewal applications.

While many services, including Medicaid and CHIP, are not affected by the shutdown, school lunches and housing assistance face challenges as do families reliant on income from federal employment.  

What can you do?

1) If you work with SNAP recipients, spread the word about the likely timing of distributions

2) Contact your federal representatives and let them know what you think about options for reopening the government

 

Issue Area:
Health
January 17, 2019

Health coverage in Connecticut: HUSKY Health fact sheets

We have created a series of fact sheets to document how Connecticut’s HUSKY Health programs impact a wide range of the state’s residents and services. You can download them below:


Husky Health Programs for Children and Families in Connecticut - an Overview


How Medicaid Supports Work and the State Economy


Medicaid and Education


Medicaid and the Child Welfare and Juvenile Justice Systems

We also have created a fact sheet with links to more sources.

Issue Areas:
Family Economic Security, Health
Tags:
coverage, Fact Sheets, Healthcare, HUSKY, insurance
January 15, 2019

Healthcare in 2019 - What to Expect

Karen Siegel, M.P.H.

Health insurance coverage rates are slipping

Connecticut’s HUSKY (Medicaid and CHIP) programs are key to our state’s health and economic success. Medicaid coverage has an enormous impact: it reduces poverty, provides lifelong benefits for children, and helps to reduce infant mortality rates. Children are more likely to have insurance and to see a doctor when their parents are insured; so, covering whole families is especially important. Being insured means parents with chronic conditions can stay healthy enough to work and parent well. It also means freedom from exposure to catastrophic medical debt for families and less uncompensated care for hospitals and clinics. Further, Connecticut’s HUSKY program is fiscally efficient, boasting the lowest per member per month Medicaid costs nationwide.

Maintaining the HUSKY programs is a key part of working towards ensuring all of our state’s residents have health insurance coverage. HUSKY expansion helped raise the rate of Connecticut residents who have health insurance to one of the highest in the nation. Yet, recently released 2017 American Community Survey data suggests that while insurance coverage rates in the nation continue to improve, in Connecticut they are at best stable and likely decreased by roughly 20,000 individuals from 2016 to 2017.

Since 2015, the legislature has twice voted to cut Medicaid income eligibility levels for parents/caregivers. We cannot afford to balance the state budget by putting families at risk of preventable disease and economic instability.

Health insurance quality at risk

Having health insurance helps people access care, but being insured alone is not enough. For Connecticut’s families to avoid preventable illness or complications, health insurance must pay for services that families need to stay healthy. Proposals at the state and federal levels threaten to erode what it means to have health insurance coverage. These include allowing short-term and “junk” insurance plans, consolidation of providers through hospital mergers and the Aetna/CVS merger—which could limit access and increase costs, and efforts to trim the state budget by covering fewer benefits for Medicaid enrollees. 

When parents have to choose between paying out of pocket towards a high deductible or paying a utility bill, they are likely to forgo or put off treatment. Inexpensive measures that could prevent a crisis—like a vaccination or a checkup—keep health care costs down.

Recent attempts to trim the Medicaid budget have targeted dental coverage and primary care provider rates. When Connecticut raised Medicaid reimbursement rates for primary care, provider participation increased, meaning more Medicaid patients were able to make appointments for routine care. Given the state fiscal crisis, Medicaid is likely to be targeted again. Additional cuts will cause real harm to real families.

Connecticut should join nearby states by adopting paid family and medical leave

Paid parental leave leads to a host of positive life outcomes for both parents and children, including decreased infant mortality, decreased child behavioral problems, decreased rates of maternal post-partum depression, and increased rates of father involvement throughout childhood. Children begin building vital brain architecture from the time they are born. By giving parents time to develop secure attachments with their new child, family and medical leave plays an important role in nurturing healthy child development for biological and adoptive parents.

Often, workers lacking paid family and medical leave hold low-income and/or multiple part-time jobs, and so cannot afford to take time off. Workers who take time off with no pay or reduced pay report borrowing money, enrolling in public assistance, putting off paying bills, and cutting their leave short. Family medical leave strengthens families’ economic stability and alleviates stress by allowing parents to care for their children without financial hardship.

Further, paid family medical leave is a smart way to improve Connecticut’s workforce. Access to paid family medical leave results in workers taking better care of their health, taking fewer risks, taking fewer and shorter sick leaves throughout the course of their careers, and having less inpatient care. Further, leave is paid for by employees, as detailed in the plan Connecticut has come close to adopting.

Opportunities to promote healthy, stable, and safe communities

Racial and ethnic disparities in health cannot be addressed in the clinic or hospital alone. To promote health equity, it is necessary to enhance community-based services and connect people to what they need in the places where they live, play, study, and work. For example, by connecting the parent of a child with chronic asthma to resources that can remove mold or offer pest-control for the family home, emergency room visits can be decreased while the family’s wellbeing increases. Community health workers can help bridge the gap between doctors’ visits and life at home, helping to identify non-medical causes of health issues and find resources to address these. Community health workers can also help empower families to play a bigger role in their care or help families to incorporate lifestyle changes in response to a diagnosis or addiction.

Opportunities to promote these strategies and to link communities to medical providers and vice versa include soon to be released proposals by the Office of the State Health Innovation Model, the recently announced federal Integrated Care for Kids grant and recently passed federal funding to address opioid addiction.

Opportunities to promote lifelong mental health starting at birth

In the first thousand days of life, children’s brains develop rapidly, making this period an especially important one for promoting health and preventing illness. Identifying and addressing children’s and families’ needs early on can prevent a lifetime of struggling to learn or coping with mental health challenges. Whole-family approaches can support children in developing resilience and other protective factors while supporting caregivers to respond to challenges in productive ways.

Opportunities to access additional federal funding mentioned above and through the Families First Prevention Services Act could also be used to bolster our state’s behavioral health system, especially for young children. Connecticut is poised to take advantage of these resources and to leverage the State Health Innovation Model to promote positive outcomes for children by improving the links between pediatricians’ offices and the state’s home visiting and community-based early childhood efforts.  Connecticut is the birthplace of robust, best-practice initiatives like Help Me Grow and Birth to Three and home to an array of home-visiting and screening programs, but these programs remain underfunded and links between programs, schools, and medical care providers could be improved.   

Issue Area:
Health
Tags:
health, Healthcare, HUSKY, insurance
December 19, 2018

Updates: Farm Bill Passes and Legal decision on the Affordable Care Act to be Appealed

Karen Siegel, M.P.H.

It was a busy week in national health news. First, the long-stalled Farm Bill, which includes SNAP (Supplemental Nutrition Assistance Program, formerly Food Stamps), passed both houses of Congress. The final bill is a bipartisan compromise that preserves SNAP without imposing the draconian cuts included in earlier drafts.  This means that Connecticut families can continue to count on SNAP to put food on the table in lean times.

On the day the President is expected to sign the Farm Bill into law, the USDA announced a proposed rule to restrict states’ ability to provide SNAP benefits to adults without dependent children living in high-unemployment areas. This rule, which would affect roughly 39,000 Connecticut residents, will be posted for public comment in the near future.

Also last week, a judge in Texas declared the Affordable Care Act (ACA) unconstitutional. The ruling found that without the tax penalty for failing to purchase health insurance, which ends this year, the entirety of the Affordable Care Act cannot stand. Legal experts have responded by calling the ruling unsound. Should this ruling eventually take effect, it would abolish Medicaid expansion (HUSKY D in Connecticut), health insurance subsidies, and consumer protections, affecting hundreds of thousands of Connecticut residents.  The good news:  For now, nothing changes while the decision works its way through the appeals process. Individuals who are uninsured can still sign up for health coverage through Connecticut’s health insurance exchange, Access Health CT, through January 15. Many qualify for subsidies through the exchange. Residents may sign up for HUSKY throughout the year. 

Issue Area:
Health
Tags:
ACA, farm bill, food stamps, health, SNAP

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