Insurance for the Uninsured

Many people in Connecticut are currently without health insurance, usually because they think they can’t afford it, are unemployed or are at higher risk due to pre-existing conditions. Fortunately, thanks to new laws and easier accessibility to coverage, there are a number of options available through AccessHealthCT.com to help both individuals and families.

HUSKY Plan

The HUSKY Plan is a state-sponsored plan that offers a full health insurance package regardless of family income for children and teenagers up to age 19. HUSKY pays for doctor visits, prescriptions, vision and dental care, and much more. Connecticut also offers HUSKY Plus, which provides additional services for children with special physical health care needs, while mental health and substance abuse treatment services are available through the Connecticut Behavioral Health Partnership.

Children enrolled in HUSKY can use doctors and other health care providers participating in one of several program health care options. Regardless of which program you choose, the actual health care benefits in each HUSKY package are the same.

For most families, HUSKY is low-cost or free. But even families with high incomes can get HUSKY health care for children at a group rate.

HUSKY serves children and teens in Connecticut’s working families, keeping them healthy and helping family budgets. HUSKY also provides health coverage for parents, relative caregivers and pregnant women, depending on income.

Getting further information about HUSKY is easy. Just call the toll-free number 1-877-CT-HUSKY (1-877-284-8759) or visit their website.

Medicaid for Low-Income Adults

Connecticut is the first state to receive federal approval to expand Medicaid under the Affordable Care Act (national health care reform legislation). This new Medicaid coverage is replacing the State-Administered General Assistance (SAGA) medical program.

Medicaid for Low-Income Adults (MLIA) is open to Connecticut residents aged 19 through 64, who do not receive federal Supplemental Security Income or Medicare and who are not pregnant. It provides full Medicaid health coverage/benefits, including:

• Long-term care/skilled nursing facility
• Home health care
• Non-emergency medical transportation

Unlike the SAGA medical program, in Medicaid for Low-Income Adults:

• There will be no asset test for eligibility;
• There will be no digital imaging requirement;
• There will be no recovery from liens on home property; and
• Redetermination (coverage renewal) will soon be done on an annual basis, not every six months

Medicaid for Low-Income Adults is administered directly by the Connecticut Department of Social Services. This is a change from the SAGA medical program, which was coordinated by the Community Health Network of CT for the Department of Social Services. For more information on the program or to see if you’re eligible, visit the Department of Social Services.¹

The Patient Protection and Affordable Care Act

How the Health Care Law is Making a Difference for the People of Connecticut

Preventing illness and promoting health

Since 2010, Connecticut has received $23.8 million in grants from the Prevention and Public Health Fund created by the Affordable Care Act. This fund was created to support effective policies in Connecticut, its communities, and nationwide so that all Americans can lead longer, more productive lives.

Increasing support for community health centers

The Affordable Care Act has increased the funding available to community health centers in all 50 states, including the 188 existing community health centers in Connecticut. Health centers in Connecticut have received $45.3 million to create health center sites in medically underserved areas, enabled health centers to increase the number of patients served, expanded preventive and primary health care services, and/or supported major construction and renovation projects.

Strengthening partnerships with Connecticut

The law gives states support for their work to build the health care workforce, crack down on fraud, and support public health. So far, Connecticut has received more than $81.2 million from the Affordable Care Act. Examples of Affordable Care Act grants not outlined above to Connecticut include:

• $1.2 million for health professions workforce demonstration projects, which will help low income individuals receive training and enter health care professions that face shortages.
• $2 million to help Connecticut reduce health care fraud by identifying efficient and effective procedures for long-term care facilities to conduct background checks on prospective employees, thereby protecting its residents.
• $3.0 million for school-based health centers, to help clinics expand and provide more health care services such as screenings to students.
• $350,000 to support outreach to eligible Medicare beneficiaries about their benefits.
• $500,000 to support Aging and Disability Resource Centers (ADRCs). ADRCs help seniors, people with disabilities, and their families understand and evaluate their long-term care options, including those available in their community.
• $286,700 for Family-to-Family Health Information Centers, organizations run by and for families with children with special health care needs.
• $832,000 to support the Personal Responsibility Education Program, to educate youth on both abstinence and contraception for the prevention of pregnancy and sexually transmitted infections, including HIV/AIDS.
• $700,000 for disease demonstration projects, to test approaches that may encourage behavior modification among Medicaid beneficiaries and determine solutions.
• $10.5 million for Maternal, Infant, and Early Childhood Home Visiting Programs. These programs bring health professionals to meet with at-risk families in their homes and connect families to the kinds of help that can make a real difference in a child’s health, development, and ability to learn – such as health care, early education, parenting skills, child abuse prevention, and nutrition.
• $4 million from the Pregnancy Assistance Fund to provide pregnant and parenting teens and women with a seamless network of supportive services to help them complete high school or postsecondary degrees and gain access to health care, child care, family housing, and other critical support.²

Health Disparities and the Affordable Care Act

The Affordable Care Act has and continues to help reduce disparities by making improvements in:

Preventive care. Medicare and some private insurance plans cover recommended appointments like regular check-ups, cancer screenings, and immunizations at no additional cost to eligible people.

Coordinated care. The law calls for investments in community health teams to manage chronic disease. This is important, because minority communities experience higher rates of illness and death for chronic diseases such as diabetes, kidney disease, heart disease, and cancer. Because infant mortality and post-birth complications are also higher in minority and low-income groups, the law includes funding for home visits for expectant mothers and newborns.

Diversity and cultural competency. The Affordable Care Act expands initiatives to increase racial and ethnic diversity in the health care professions. It also strengthens cultural competency training for all health care providers. Health plans are required to use language services and community outreach in underserved communities. Improving communications between providers and patients helps address health disparities particularly in Hispanic communities, which historically have high numbers of uninsured people.

Health care providers for underserved communities. The Affordable Care Act and increases funding for community health centers, which provide comprehensive health care for everyone no matter how much they are able to pay. Health centers serve an estimated one in three low-income people and one in four low-income minority residents. The new resources will enable health centers to double the number of patients they serve. Combined with investments made by the American Recovery and Reinvestment Act, the law supports 16,000 new primary care providers.

Ending insurance discrimination. Insurance discrimination is now banned, so people who have been sick can’t be excluded from coverage or charged higher premiums. Women no longer have to pay higher premiums because of their gender. New funding is available to collect information on how women and racial and ethnic minorities experience the health care system, leading to improvements that will continue to benefit these groups.

Affordable insurance coverage. Health insurance marketplaces, established in 2014, offer one-stop shopping so individuals can compare prices, benefits, and health plan performance on easy-to-use websites. The Exchanges guarantee that all people have a choice for quality, affordable health insurance even if a job loss, job switch, move, or illness occurs. The law also provides tax credits to help more Americans pay for insurance. Learn more about Affordable Insurance Exchanges.³

Coverage for Young Adults. The law generally allows young adults, including those with disabilities and chronic conditions, to stay on their parents’ plan up to age 26 even if they do not live with their parents or if they graduate from school.

New Out-of-Pocket Limits. Starting in 2014, all non-grandfathered plans will be required to limit the amount you pay in out-of-pocket expenses annually, such as co-pays and deductibles.⁴