What CT has done and still needs to do to help folks impacted by COVID-19
The coronavirus pandemic has highlighted just how fragmented and dysfunctional our current health care system is. Efforts are underway to plug some of the holes, but many gaps remain. Here are some highlights of the good, the bad and the ugly of the effort to provide access to health coverage and care to the people of Connecticut.
Access Health CT and Medicaid
We are fortunate to live in a state where the Affordable Care Act (ACA) marketplace, Access Health CT, is able to make its own decisions regarding the timing of open enrollment periods. Very early on in the COVID-19 crisis, Access Health CT announced a “special enrollment period”, to allow people who are uninsured to get coverage. Originally running from March 19-April 2, the date has just been extended through April 17.
Those who are losing their insurance coverage due to a lay-off have even more time to enroll: 60 days from the date of their lay off.
Most people qualify for extra help to cover the cost of premiums, depending on their family’s size and income.
Those who qualify for Medicaid can also apply through Access Health CT and can enroll at any time. This coverage is based on income only, not on assets like owning a home or how much money you have in the bank. See resources below for information about income eligibility.
By far the biggest coverage gap is that immigrants, depending on their status, are unable to access coverage at all. State government should be stepping up to expand coverage.
Affordability
There is positive movement on this front as well. A recent executive order from Governor Lamont protects individuals and employers from having their insurance coverage dropped for lack of payment. This grace period is for 60 days, beginning April 1.
Many insurers are announcing they are voluntarily suspending all out-of-pocket payments for people who are tested or treated for COVID-19. Both Cigna and Anthem are doing this, and Aetna is protecting people from inpatient costs. But many of these policies are limited to “in-network” care. As Connecticut’s hospitals begin to fill up, patients will have little to no choice about where they will be treated and too sick to ask questions about provider networks. And for most people who are privately insured through a large employer, it is actually up to the employer to waive out-of-pocket costs.
Meanwhile, other medical care needs haven’t disappeared. Those being treated for other conditions, of course, are still stuck with the same high deductibles, co-pays and co-insurance charges. So, the ongoing worries people have always had about paying for coverage and care continue.
Furthermore, because insurance coverage is often tied to employment, those losing their jobs are losing their health coverage at the same time. The stimulus package passed by congress last week includes extra support for people filing for unemployment of $600 per week for the next 13 weeks. But while that extra boost will certainly help people pay their housing and food costs, it may lower the amount of premium subsidies they will be eligible for through Access Health CT.
We Need To Do More
While Connecticut has done a lot, there are other states who are outpacing us in coverage and affordability protections. These maps from the Commonwealth Fund show that we could do better, particularly when it comes to out of pocket protections for testing and treatment. We should follow their lead and codify these protections via Executive Order. And that codification should cover people regardless of whether they are in or out of network.
We should do everything we can to use Medicaid to cover more immigrants-not just for COVID-19 testing, but for treatment as well.
Finally, we should do everything we can to let people know what they are eligible for, staff up enrollment capacity, and streamline enrollment processes so people can access the coverage and care they so desperately need.
Fixing Our Broken System
We are in the midst of the biggest health and financial crisis of our lifetimes. It is highlighting what we have always known and continue to fight for: everyone should have access to health coverage and care, no questions asked. Instead we have a highly fragmented system that leaves too many people out and is way too complex.
Right now, we need to demand that our state cover as many people as possible with as little financial worry as possible. And, looking toward the future, we need to redouble our efforts to gain access to quality, affordable health care for everyone.
Resources
Access Health CT special enrollment period for previously uninsured people: call 855-365-2428. Go HERE to learn more.
Access Health CT web site to enroll if you were laid off and have now lost your coverage
Single individuals are eligible for Medicaid if their annual income is under $17,236. For Medicaid income eligibility information for families, go HERE
Governor Lamont’s April 1, 2020 Executive Order (see #2 on page 3)
Millions of Americans Are About to Lose Their Health Insurance in a Pandemic, Wendell Potter, The Guardian, March 27, 2020
The Missing Piece in the Coronavirus Stimulus Bill: Relief for Immigrants, Nicole Narea, Vox, April 1, 2020