Connecticut’s Medicaid program provides coverage for necessary medical care to more than one million Connecticut residents. But there are some glaring inequities that currently exist in the Medicaid program and pending bills before the Connecticut Legislature can help address them.
But only one of the bills actually ends harmful discrimination against people with disabilities and the elderly, while the other maintains it – only to a lesser extent.
There are several different Medicaid programs in Connecticut, and which program you qualify for depends on whether you are a parent/caregiver, your age, whether you are disabled, whether you have a certain medical condition, and whether you are working. Each program has income limits, and two (those that apply to people with disabilities) have asset limits. You may be surprised to learn that the Medicaid program with lowest income and asset limits is the program for people who are elderly and/or disabled and unable to work – people usually think that most vulnerable — HUSKY C.
HB 6630, which has passed out of the Human Services Committee and is currently in the Appropriations Committee, would raise the income limit for HUSKY C to 138% of poverty (currently $1,677/month), matching the income limit for the HUSKY program D (which covers adults who are under 65 and generally not disabled) and will raise the asset limit to $10,000 for a single person/$15,000 for a couple to match the MED-Connect program (which covers people with disabilities , who also have earned income). This proposal is the right, fair, and just thing to do, and it follows the example of New York and California, which have already ended discrimination by raising income limits for their Medicaid programs for the elderly and with disabilities up to 138% of the federal poverty levels.
If budgets are a moral document and people want to ensure the health of Connecticut’s “most vulnerable” residents — something every legislator claims they want to do — then the right thing to do is to pass HB 6630. And if are serious about addressing the well-documented gaps in health care access for black and brown people, who have higher rates of disability and generally lower incomes than their white counterparts, then we must also help address these disparities, fully addressing disability discrimination in eligibility for HUSKY C compared to HUSKY D.
There is an alternative proposal as part of HB 5001, but it does not raise the income and asset limits for HUSKY C to the same levels as the proposal in HB 6630. This is a partial fix. If the program’s current design constitutes systemic discrimination against older and disabled adults—which we argue it does—then a partial fix means perpetuating that pattern of discrimination. This is unacceptable and therefore the language in HB 5001 should be amended to incorporate the language of HB 6630.
There are many competing claims for surplus in budgets. But why are the people who seem to be last in line the people most in desperate need of help? Someone who is no longer able to work because of a disability and receives moderately higher Social Security disability benefits because of their own work history likely needs access to medical care to address chronic health problems and may be exposed to risk of institutionalization, if you don’t you don’t have access to the long-term services and supports that are covered by Medicaid.
When they can’t access care because they don’t have Medicaid coverage and can only access it through the process of “spending down” their “excess income” – they suffer. Or they end up in the emergency room, racking up a big bill that ironically can help them cover those costs and then have access to Medicaid until the next six-month spending period begins.
There is no way if a program was designed from scratch it would be designed this way. The current system literally incentivizes the use of one of the most expensive parts of the health care delivery system, the emergency room, because emergency rooms are obligated to stabilize someone who shows up at their door. Instead, we could ensure that people have full access to the care they need. We could also enable people to save extra money to deal with emergency expenses or a security deposit for a new apartment, instead of having to keep their savings below the extremely low asset limit ($1,600) that was literally defined in the early 1970s.
HB 5001 is only a partial solution for people needing nickel and diming. It still discriminates based on disability and age. Somewhat reduced level of discrimination is still discrimination. We are better than that.
We urge the Appropriations Committee to include funding in their budget to raise the revenue and asset limits for HUSKY C as outlined in HB 6630.
Kathryn John is with Black and Brown United in Action. Holly Hackett is the Outreach and Outreach Coordinator for the Keep the Promise Coalition.