Human Services Committee
JOINT FAVORABLE REPORT
Bill No.: SB-1056
Title: AN ACT EXPANDING ACCESS TO MEDICAL ASSISTANCE.
Vote Date: 4/1/2021
Vote Action: Joint Favorable Substitute
PH Date: 3/25/2021
File No.:
Disclaimer: The following JOINT FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
Human Services Committee
REASONS FOR BILL:
The bill proposes to raise the income limits for several categories of Medicaid coverage in
Connecticuts Medicaid program. It would raise the eligibility for most categories of Medicaid
eligibility to 200% of the federal poverty level (FPL). The bill also includes a provision to
provide medical assistance to individuals under the age of 65 who do not otherwise qualify for
medical assistance but whose income is between 133% and 200% of FPL. The substitute
language adds income disregards for HUSKY C from 100% of the FPL to 200% of the FPL, in
conformance with federal law. This bill seeks to provide expanded access to comprehensive,
affordable healthcare coverage to improve the quality of life for Connecticut residents.
RESPONSE FROM ADMINISTRATION/AGENCY:
Deidre Gifford, Commissioner, Department of Social Services explains that the proposed
changes in this bill would greatly increase eligibility. Currently, the income eligibility for
HUSKY C is up to 143% of the Temporary Family Assistance (TFA) payment standard, which
varies based on geographical region. Commissioner Gifford comments that federal law only
allows coverage of the aged, blind and disabled category up to 100% of the FPL, but they
may qualify for Medicaid through a home and community-based services waiver or a spend-
down of their income. She also notes that if Connecticut were to expand HUSKY D coverage
beyond 133% of the FPL, it would not receive the enhanced federal medical assistance
(FMAP) for the population between 134% and 200% of the FPL. Since these proposed
eligibility increases would significantly increase enrollment and expenditures, and there is no
allocation in the Governors budget for these costs, the Department opposes this bill.
NATURE AND SOURCES OF SUPPORT:
Senator Martin Looney, President Pro-Tempore supports this bill because it expands
coverage to uninsured individuals who have incomes just above the current Medicaid
threshold. Individuals with incomes between 100% and 200% of the FPL make up 13% of
Connecticuts population, but 26% of the states uninsured residents. Sen. Looney notes that
the bill would prevent a benefits cliff that will be created by the scheduled minimum wage
increases. He believes that the state should create a gradual decrease in benefits for
individuals whose incomes rise above the allowable limits for benefits.
Sheldon Toubman, Attorney, New Haven Legal Assistance Association
Alison Weir, Policy Advocate and Attorney, Greater Hartford Legal Aid
Luis Perez, President and CEO, Mental Health Connecticut (MHC)
They support this bill because the pandemic has shown that access to comprehensive,
affordable insurance is necessary. They all recommend increasing the income level for
individuals over 65 because their needs are the same as those who are under 65 years old.
Mr. Toubman and Ms. Perez note that some elderly and disabled individuals with incomes
over 200% FPL will still have large medical bills which could be used to qualify for Medicaid
under spend-down. Since Connecticut is a 209b state they state that it is required under
federal Medicaid law that spending down continue to be allowed for this population. Mr.
Toubman and Ms. Weir explain that the best route to achieve 200% of the FPL for this
population would be to raise the income disregard.
Ellen Andrews, Executive Director, CT Health Policy Project
Marijane Carey, Maternal and Child Health Consultant, CT Maternal and Child Health
Coalition (MCH) and Every Woman CT (EWCT)
Rosana G. Ferraro, Universal Health Care Foundation of CT
Sandra Olsen
Maura Sheil-Hughes
They strongly support this bill because restoring HUSKY coverage for working parents and
expanding it for adults in all categories, benefits families, communities, and the state budget.
They emphasize that this bill would restore HUSKY A parent eligibility to 200% of the FPL.
This restoration of eligibility would include over 11,200 parents who lost access to coverage
in 2015. Ensuring coverage for these parents would greatly improve the health and safety of
families across the state. This restoration is needed because although AccessHealthCT is a
lifeline for thousands of CT residents, it is not affordable for many working families.
Kenneth Barela, Chief Executive Officer, Hispanic Health Council (HHC),
Katia Daley, Healthcare Campaign Organizer, CT Students for a Dream
Kathleen Flaherty, Executive Director, CT Legal Rights Project
Gretchen Raffa, Senior Director, Planned Parenthood of Southern New England
Karen Siegel, Director of Policy, Health Equity Solutions
They support this bill because it addresses the inequities in accessing health insurance
experienced by low-income communities, primarily immigrants and communities of color. Ms.
Daley notes that this bill will expand the accessibility to affordable healthcare to more mixed-
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status immigrant families. In light of the COVID-19 pandemic, which has illuminated the
systematic inequities that these communities face, they believe Connecticut has a
responsibility to ensure these communities have health coverage. When individuals lack
coverage or are under-insured, they avoid or delay seeking care. This leads to increased
illness, complications, and mortality, which results in higher costs for the state.
Sylvia Cooper, Ministerial Health Fellowship Advocacy Coalition
Monica Dawkins
Christian Kallfelz
Maura Sheil-Hughes
Katherine Villeda
They all believe that healthcare is a human right and increasing access to medical assistance
is vital for achieving health equity. All testifiers speak to the critically important value of having
HUSKY available to access lifesaving care. They urge the passage of this bill so that more
Connecticut residents have health insurance they can afford to use. They emphasize the
importance of preventative care, and how it inhibits conditions from being undetected and
exacerbated. A few testifiers note that increasing eligibility for HUKSY programs is vital as the
minimum wage continues to increase.
Rosana G. Ferraro, Universal Health Care Foundation of CT
Gretchen Raffa, Senior Director, Planned Parenthood of Southern New England
Maggie Goodwin, National Organization for Women
They support this bill because increasing the number of CT residents with affordable health
insurance brings the state closer to universal coverage. This bill is critical to provide coverage
for individuals who cannot afford private insurance, despite their eligibility for financial help on
the state exchange. It is extremely challenging for individuals living under 201% of the
Federal Poverty Line to afford the cost-sharing elements that come with private insurance. All
testifiers request that low-income elderly people be included in this expansion because they
struggle to afford care and services that Medicare does not cover. They also request
including all immigrants regardless of status; the uninsured rate for the undocumented
population is 52% in our state.
Ms. Goodwin also adds that many women who recently received a raise due to increased
minimum wage income will be priced out of Medicaid coverage and unable to afford coverage
through AccessHealthCT.
The Connecticut Agencies on Aging
Stephen Wanczyk-Karp, Executive Director, The National Association of Social Workers
(NASW/CT)
Susan Salters
They support this bill because the current income limitations, specifically for HUSKY C, are
too low. The CT Agencies on Aging state that they leave individuals living in poverty by
federal standards without access to basic health care expense relief. In most parts of the
state, the income limits for this program are at 82% of the FPL. This leaves many seniors with
the decision of paying for health care expenses or other basic necessities. The CT Agencies
on Aging note that spend-down rules are complex and very difficult for an elder to navigate,
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sometimes leading to premature institutional placement. NASW/CT recommends an
amendment to include all elderly persons who are income-eligible because Medicare does
not cover certain services that HUSKY offers.
Mr. Wanczyk-Karp notes that aligning income eligibility for HUSKY A, B, C will eliminate the
current confusion amongst applicants. He also added that more coverage through HUSKY
results in less uncompensated care, more preventative care, expansion of coverage in Black
and Latino communities, and maximization of federal matching funds.
Pareesa Charmchi Goodwin, Executive Director, CT Oral Health Initiative notes that lack of
coverage and high cost of care are the primary reasons people forgo seeking healthcare.
Expanding access to HUSKY would provide people with comprehensive coverage without co-
payments. This will encourage people to seek preventative care, which will result in improved
health outcomes and major cost savings for the state. Ms. Goodwin notes that dental
coverage in Medicaid helps adults obtain and maintain employment and reduces costly
emergency room visits.
Thomas Stovall, MPH Candidate supports this bill because it is a step towards lowering the
number of uninsured people in Connecticut. Mr. Stovall notes that the highest percentage of
uninsured people in our state lies within the 100-199% FPL range. He states that
Connecticut has one of the most consolidated individual insurance markets. This lack of
competition contributes to the lack of affordable insurance available to this population.
NATURE AND SOURCES OF OPPOSITION:
There were none expressed.
Reported by: Gianna Vollano Date: April 16, 2021
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