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Voices Speaking

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
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

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