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Connecticut health insurance

Connecticut rated 4th healthiest state, embraces health reform

To help you assess health-related quality of life measures in The Constitution State, here is a brief summary of health rankings and the state’s rollout of the Affordable Care Act.

Connecticut health ratings

By many measures, public health is a positive for the state of Connecticut.

Connecticut is sixth in overall health according to the Scorecard on State Health System Performance 2014, ranking among the top 25 percent in four categories: access, prevention and treatment, healthy lives, and equity. See Connecticut’s Scorecard for measures in each category and how Connecticut scored.

Connecticut ranked 4th in America’s Health Rankings for 2014, up from 7th in 2013. The state earned high marks for low rates of smoking and occupational fatalities, as well as high immunization coverage among children. It saw big improvements in physical inactivity, diabetes and preventable hospitalization rates in recent years. Connecticut’s biggest health challenges, according to this ranking, include binge drinking, disparity in health status among people of different education levels and public health funding.

For additional health indicators, see Key Health Data About Connecticut from the 2014 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. See data for Connecticut.

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 in August 2014.

How Obamacare is helping CT’s uninsured

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.

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.

In 2014, sixty-three percent of Connecticut’s uninsured residents were eligible for either Medicaid or for subsidies to purchase private coverage through the insurance marketplace, according to the Kaiser Family Foundation.

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.

By mid-2015, 92,213 people had effectuated private coverage through Access Health CT (that number grew to 96,621 by mid-September 2015); 78 percent of them were receiving premium subsidies.

Anthem, ConnectiCare, and HealthyCT sold medical insurance policies through Access Health CT for the 2014 plan year. HealthyCT is a new insurer, established through the ACA’s Consumer Operated and Oriented Plan (CO-OP) Program. The CO-OP program offered loans for the creation of consumer-friendly, nonprofit insurers to increase competition in the individual and small-group markets. HealthyCT received a $79.6 million loan, and was one of 23 CO-OPs established across the U.S. As of November 2015, several CO-OPs had announced their closure by year-end; however HealthyCT continues to offer coverage.

For 2015, UnitedHealthcare joined the Connecticut marketplace, and will continue to offer plans in the exchange in 2016.

Individual market carriers in the Illinois exchange:

  • Anthem
  • ConnectiCare Benefits
  • Healthy CT
  • UnitedHealthcare

Individual market carriers outside the exchange:

  • Aetna
  • Anthem
  • Celtic
  • Cigna
  • ConnectiCare Inc.
  • ConnectiCare Insurance Company
  • Golden Rule
  • Healthy CT
  • UnitedHealthcare

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 718,811 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.

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.

Medicare enrollment in Connecticut

Connecticut Medicare enrollment reached 627,535 in 2015 – about 17 percent of the state’s population and on par with the percentage of people enrolled in Medicare nationwide. About 85 percent of Connecticut Medicare recipients qualify based on age alone, while 15 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 $11,085 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 26 percent make this choice. Thirty-two 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-three percent of all Medicare enrollees have Medicare Part D plans.