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Connecticut health insurance

CT residents have until December 22, 2017 to enroll in coverage for 2018; Connecticut high risk pool coverage terminates at the end of December 2017

Connecticut enrollment updates

Connecticut overview

Open enrollment for 2018 health insurance plans began November 1, and ends December 22, with all plans effective January 1, 2018. Connecticut runs what is lauded as one of the most successful state-run exchanges, has expanded Medicaid under the Affordable Care Act, and tops the charts when it comes to health rankings.

Yet, Connecticut residents are experiencing some of the same pains as others nationwide. Rates for individual plans in CT increased by an average of 29.3 percent for 2018, although premium subsidies have grown substantially, due in part to the cost of CSR being added to silver plan premiums in Connecticut. Carrier options for those shopping Connecticut’s exchange dwindled in 2017, with the exit of HealthyCT and UnitedHealthcare at the end of 2016. But the two remaining insurers (Anthem and ConnectiCare) are continuing to offer coverage for 2018.

Republicans in Congress passed legislation in December 2017 that will eventually repeal the ACA’s individual mandate, but that change won’t take effect until 2019. For 2018, residents in Connecticut and across the country will have to maintain health insurance or face a tax penalty.

Connecticut health ratings

By many measures, public health is a positive for the state of Connecticut, which tied with New Hampshire for 7th paced in the 2017 Scorecard on State Health System Performance. Connecticut ranked among the top 25 percent in 33 categories, performing exclusively in the top 10 for all health indicators related to access (e.g., uninsured rates, dental visits, routine doctor visits).

America’s Health Rankings 2015 ranked Connecticut 6th overall, but it rose one spot, to 5th, in the 2017 rankings. In all but three measures – public health funding, excessive drinking and disparity in health status – the state ranked in the top 25 percent. For additional health indicators, see Key Health Data About Connecticut from the 2016 edition of Trust for America’s Health.

Finally, the Robert Wood Johnson Foundation and the Population Health Institute at the University of Wisconsin publish county-by-county health rankings. All but one county, Fairfield, was at or below the national uninsured rate. See data for Connecticut for more details.

How Obamacare is helping CT’s uninsured

Connecticut opted for a state-based exchange, Access Health CT, and expanded Medicaid under the Affordable Care Act. There are conflicting data in terms of the uninsured rate in Connecticut, but by any metric, the rate has dropped considerably since the ACA was implemented. Nine out of 10 Connecticut residents now have healthcare coverage.

Access Health CT stated in 2014 that the uninsured rate had been cut in half since 2013, falling from 8 percent to 4 percent. According to Gallup data, the uninsured rate in Connecticut was 12.5 percent in 2013, and fell to 5 percent in the first half of 2015. And US Census data put Connecticut’s uninsured rate at 4.9 percent in 2016 (one of seven states with an uninsured rate under 5 percent), down from 9.4 percent in 2013.

Connecticut rates, health plans for 2018

Connecticut residents had two insurers offering health plans through the exchange for 2018, and both are continuing to offer coverage for 2018: Anthem and ConnectiCare. The overall average rate increase is about 29 percent, but that includes the cost of cost-sharing reductions being added to silver plan premiums, which drives average prices higher than they would otherwise be, but also results in premium subsidies that are disproportionately larger than the premium increases for non-silver plans.

While the state’s ACA-created CO-OP, HealthyCT, outlasted many, it shut down at the end of 2016. Additionally, UnitedHealthcare ceased to offer exchange-based plans in Connecticut at the end of 2016. But the impact was still fairly insignificant, as those two carriers accounted for just 12 percent of exchange enrollment in 2016.

Enrollment in qualified health plans

Early in the 2014 ACA open enrollment period, the Kaiser Family Foundation estimated the market size for Access Health CT at 216,000. Ultimately, 79,192 people, or 36.7 percent of the potential market, enrolled in qualified health plans (QHPs) through Connecticut’s health insurance exchange during the first open enrollment period. Connecticut ranked seventh for percent of the potential market that enrolled during the first year of marketplace operations.

With 116,019 enrollees, Connecticut’s 2016 enrollment increased 5 percent over 2015 and was above the high-end goal Access Health CT set for the year. Thirty-two percent of the exchange’s 2016 enrollees were new and 78 percent were receiving premium subsidies. As of March 2016, about 35 percent of Connecticut’s potential marketplace population was enrolled.

111,542 people enrolled in coverage for 2017 through Access Health CT. And for 2018 coverage, enrollment through Connecticut’s exchange stood at 106,000 people as of December 20, which was two days before the December 22 end of open enrollment.

Connecticut and the Affordable Care Act

The Affordable Care Act was unanimously supported by Connecticut’s delegation to the U.S. Congress. Sen. Christopher Dodd, a Democrat, and Joseph Lieberman, an Independent, both voted to pass the Affordable Care Act in 2010, as did all five of Connecticut’s Democratic representatives.

Both senators have since left office, with Dodd replaced by Richard Blumenthal and Lieberman replaced by Chris Murphy. Both Blumenthal and Murphy are Democrats and supportive of the ACA.

Murphy previously represented Connecticut’s 5th District. When he moved to the Senate, Elizabeth Esty – a Democrat who supports the ACA – was elected to the seat. Esty and the four representatives who voted in support of the ACA were re-elected in 2014.

At the state level, Gov. Daniel Malloy supports the ACA. State lawmakers passed legislation authorizing a state-run insurance marketplace. Malloy signed the bill into law on July 1, 2011. Malloy was re-elected in 2014.

The state marketplace was named Access Health CT in December 2012. Access Health CT has been one of the country’s most successful marketplaces, with few technical problems and robust enrollment. Access Health CT’s CEO, Kevin Counihan, was named CEO of Healthcare.gov in August 2014.

Connecticut Medicaid

In 2010, Connecticut was the first state to adopt Medicaid expansion, and it again expanded eligibility criteria for the program at the beginning of 2014.

As of August 2015, there were 771,512 people enrolled in Connecticut Medicaid.

Learn about Connecticut health care programs for low-income and disabled individual as well as others with specific needs.

Does Connecticut have a high-risk pool?

Prior to the reforms the ACA brought to the individual health insurance market, coverage was underwritten in nearly every state, including Connecticut. That left people with pre-existing conditions often unable to purchase a plan at all, or only eligible for coverage that excluded pre-existing conditions or charged premiums significantly higher than the standard rates.

The Connecticut Health Reinsurance Association (HRA) was created in 1976 to give people an alternative if they were ineligible to purchase individual health insurance because of their medical history. (Only Minnesota has a high risk pool as old as Connecticut’s.)

As of January 2014, all new major medical policies in the individual market are guaranteed issue, thanks to the ACA. This means that there is no longer a need for high-risk pools the way there was in the past. Connecticut’s HRA board voted to discontinue new member enrollment at the end of 2013, but they did not immediately cancel coverage for existing members. They noted that they were encouraging members to transition to an exchange plan, and would reconsider ending the program if and when membership drops significantly.

Ultimately, HRA plans remained in effect throughout 2017, but are being terminated at the end of 2017. All remaining HRA members need to switch to new plans for 2018. Open enrollment in the Connecticut exchange runs through December 22, but people losing coverage under HRA plans will have a special enrollment period that continues until March 1, due to loss of coverage. However, they need to enroll in a new plan by December 31 in order to have coverage effective January 1, 2018. If they enroll after that, they’ll have a gap in coverage of at least one month.

Medicare enrollment in Connecticut

Connecticut Medicare enrollment reached 630,333 in 2015 – about 18 percent of the state’s population compared with 17 percent of people enrolled in Medicare nationwide. About 87 percent of Connecticut Medicare recipients qualify based on age alone, while 13 percent are covered as the result of a disability.

In terms of overall spending, Connecticut ranks 26th with $6.2 billion per year. Medicare pays about $9,151 annually per Connecticut enrollee.

Connecticut Medicare recipients who want additional benefits beyond what is offered through traditional Medicare can select a Medicare Advantage plan instead, and nearly 25 percent make this choice. Thirty-one percent of Medicare beneficiaries nationwide are enrolled in Medicare Advantage plans.

Medicare recipients can also gain stand-alone prescription drug coverage through Medicare Part D plans. In Connecticut, about half of all Medicare enrollees have a stand-alone Rx plan. Forty-five percent of all Medicare enrollees have Medicare Part D plans.

Helpful Connecticut health insurance links

CT health reform at the state level

Here is what’s happening legislatively with healthcare reform in Connecticut at the state level:

More Connecticut coverage

Exchange

News, history, and enrollment info for your state marketplace

Medicaid

Your state’s Medicaid expansion, eligibility, contacts

Medicare

Insurance for those over 64 (off-site)