Connecticut health insurance

CT residents see carrier options cut in half for 2017

Open enrollment for 2017 health insurance plans began November 1, and those who want coverage starting January 1 will need to enroll by December 15. 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 the same pains as others nationwide. Rates for individual plans in CT increased by an average of 24.8 percent – nearly on par with the national average increase of 25 percent. Meanwhile, carrier options for those shopping Connecticut’s exchange have dwindled with the exit of HealthyCT and UnitedHealthcare at the end of 2016.

Given the results of the 2016 presidential election, many wonder how the incoming Trump administration will impact Obamacare – and how quickly – we’ve answered those questions as best we can here. For now, Connecticut residents and others nationwide are encouraged to buy health insurance plans as they normally would.

Connecticut health ratings

By many measures, public health is a positive for the state of Connecticut, which placed 5th in the 2015 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). See Connecticut’s scorecard for additional measures in each category.

America’s Health Rankings 2015 ranked Connecticut 6th overall. 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’s 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 6.9 percent in 2015 (one of seven states with an uninsured rate under 7 percent), down from 9.4 percent in 2013.

Connecticut rates, health plans for 2017

Half of Connecticut’s exchange carriers are making their exit, leaving two carrier options for 2017 open enrollment: Anthem and ConnectiCare. Their proposed rate increases are 26.8 percent and 14.3 percent.

While the state’s ACA-created CO-OP, HealthyCT, outlasted many, it will shut down at the end of 2016. Additionally, UnitedHealthcare will cease to offer exchange-based plans in Connecticut. These two carriers account for just 12 percent of exchange enrollment.

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 are new and 78 percent are receiving premium subsidies. As of March 31, about 35 percent of Connecticut’s potential marketplace population was enrolled.

Connecticut and the Affordable Care Act

The Affordable Care Act was unanimously support 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 are not yet cancelling coverage for existing members. They are encouraging members to transition to an exchange plan, and will reconsider ending the program if and when membership drops significantly.

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.

CT health reform at the state level

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

  • Gov. Malloy signed SB 864 into law on June 19, 2015. This bill requires the study of the effectiveness of having Connecticut’s Medicaid program pay health insurance premiums for University of Connecticut–sponsored health plans for students who otherwise qualify for Medicaid. The study period began July 1, 2015, and results will be presented to lawmakers on January 1, 2015.

Other state-level health reform legislation:

Comments