Future of health insurance coverage for state residents uncertain

Jan. 06--Actions that began this week by Senate Republicans to try to dismantle the federal Affordable Care Act aren't an immediate threat to the approximately 163,000 Connecticut residents receiving health insurance through the state-run online marketplace Access Health CT, according to Lt. Gov. Nancy Wyman, head of the Board of Directors of the quasi-public marketplace.

"They will be covered for 2017," she said in a phone interview this week. "I don't think they could pull the rug out that fast."

Wyman said, however, that Access Health CT, which now provides Medicaid coverage to about 58,300 state residents and private health insurance to about 104,500, could not continue to operate beyond this year in its current form without the $1.3 billion in federal funding the state receives that is at risk if the Affordable Care Act is repealed. The funding supports the expanded Medicaid enrollment for low-income residents, and provides subsidies for other Access Health CT customers who qualify based on their incomes.

"We couldn't find $1.3 billion in our budget to take care of the Medicaid portion and the ACA portion," she said.

Access Health CT began operating four years ago as the state's response to the 2010 federal health care law. Connecticut was one of 17 states and the District of Columbia that created their own marketplaces to implement the law. Residents of other states can access health insurance through the federally run Healthcare.gov site.

The uncertainty surrounding the future of the Affordable Care Act, as well as the lack of a replacement plan proposed by the GOP, makes it very difficult for Connecticut to determine how to respond, Wyman said.

"I can't believe that after six years, they're still uncertain how they're going to proceed," she said. "We can't prepare when we don't know what they're going to come up with."

Despite that, she said, she and other Access Health CT officials are developing possible plans to find a way to maintain the state's marketplace if the Affordable Care Act is repealed.

"We're constantly working on it," she said. "What we would like is to find a way for it to become self-sufficient."

James Wadleigh, chief executive officer of Access Health CT, has been in discussions with other states with their own marketplaces "on an ongoing basis," said Kathleen Tallarita, spokeswoman for the marketplace.

During an interview last month, Wadleigh said about 13,000 new customers signed up for coverage through the marketplace for 2017. Of the 104,495 private insurance customers signed up as of Friday, about 75 percent receive a federal subsidy offsetting the cost of monthly premiums, which average about $450 per month, he said. The average subsidy is about $125 per month.

Average premiums increased from 17 percent to 22 percent in 2017 compared with last year.

Under the 2010 law, those who do not have health insurance will be charged a tax penalty of $695 or more in 2017.

In Congress on Thursday, Sen. Chris Murphy of Connecticut joined Sen. Tim Kaine of Virginia in introducing an amendment that would stop the GOP's effort to dismantle the Affordable Care Act. Called, "Don't Make America Sick Again," the amendment would prevent the Senate from considering fast-track legislation that would increase health insurance premiums and out-of-pocket costs, reduce the number of Americans with insurance coverage or reduce health insurance benefits.

"If Republicans have their way, 30 million Americans will lose their health insurance," Murphy said in a news release. "We'll go back to the day when people were denied coverage and went bankrupt simply because they got sick, and when women paid more to receive the same benefits as men."

Kaine said that while he and Murphy "acknowledge the need for improvement" in the Affordable Care Act, Republicans should not be working to repeal it without replacement legislation.

During remarks on the Senate floor, Murphy emphasized the important role the law has played in making sure that individuals with pre-existing conditions are not denied coverage, that health plans do not impose annual or lifetime dollar limits on benefits that can be received, and that all Connecticut residents receive high-quality, affordable health insurance.

Asked about how he would work to protect states like Connecticut with their own marketplaces, Murphy did not offer any specifics. He did, however, said he is "working his tail off" to prevent the repeal, which he characterized as Republicans' attempt to "take health care away from people in Connecticut -- plain and simple."

"The Affordable Care Act has done a lot of good for people in our state," he said. "Now, hundreds of thousands of our neighbors have health insurance and enjoy new benefits and protections. Women and seniors are no longer charged more for health insurance, no one has to worry about being denied coverage because they were sick or hit an arbitrary lifetime limit on medical bills, and young adults can stay on their parents' health insurance. Yes, the Affordable Care Act isn't perfect, but Congress should work together to make it better, not trash the health care that people rely on."

Sen. Richard Blumenthal on Friday announced that he will join U.S. Rep. Elizabeth Esty, D-5th District, along with health care advocates and state residents who benefit from the Affordable Care Act to warn of the "dire costs" of repealing the act. Among those attending the event at the Legislative Office Building in Hartford will be a breast cancer survivor on a fixed income whose monthly premium would skyrocket without the Affordable Care Act, and another woman whose pulmonary hypertension medications cost $250,000 without the act, Blumenthal said in a news release.

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