New lawsuit challenges Medicaid eligibility rules

Disability Rights Connecticut and the Medical-Legal Partnership Clinic filed a civil rights lawsuit against the state Department of Social Services Thursday, alleging that two residents were barred from the state's Medicaid program because of their disability and the eligibility categories.

The complaint, filed with the Hartford judicial district, claims that the state's Medicaid eligibility categories prevent disabled residents from participating in the program, violating the state Constitution's equal protection clause.

Connecticut's Medicaid program, more commonly known as HUSKY, is set up in a way that offers coverage based on specific categories, like income, age, disability and more, despite offering similar benefits across the plans. If a resident's income is too high to meet the limit of one coverage plan, they often have the option to see if they fit within the requirements for a different plan.

The lawsuit argues, however, that people with disabilities don't have the same opportunity since they are only categorically eligible for the state's Medicaid on the HUSKY C plan, which covers residents who are disabled, blind and elderly. The current monthly income limit for HUSKY C is $1,370, but it also includes asset limits of $1,600 and $2,400 for singles and couples.

Both plaintiffs make over the monthly income limit and are ineligible for the plan. Still, their disability and payments through the Social Security Disability Insurance, thus making them eligible for Medicare, made it impossible for them to look at the other coverage options through the state, specifically HUSKY D, because of the eligibility requirements, according to the complaint.

The suit names Commissioner Andrea Barton Reeves as the defendant. A spokesperson for DSS said the department is reviewing the complaint and doesn't comment on pending litigation.

"Whatever the reason or intent behind Connecticut's differential standards for disabled and non-disabled people in accessing Medicaid, the effect is the same: Plaintiffs and people like them cannot access Medicaid and thus cannot access needed healthcare," according to the complaint reviewed by CT Insider.

Connecticut expanded HUSKY in 2010 and created the HUSKY D plan to cover adults under 65 who don't fall into another eligibility category and have household incomes up to 138% of the federal poverty line, or around $1,732 a month with no asset limits. To enroll, participants also can't be eligible for federal Medicare or be pregnant.

Both plaintiffs -- Laura DiErrico and Frank Caggiano - lost their HUSKY D coverage in 2023 after the federal COVID-19 expansions that made them eligible expired. Since then, the complaint states they can't re-enroll in Medicaid coverage, impacting their day-to-day life.

According to the lawsuit, both plaintiffs do receive some health insurance coverage with the federal Medicare but it is limited in its coverage, not offering help as much coverage for dental care, vision care, hearing aids, long-term care, most home health care, non-emergency medical transport, and more.

The lawsuit asks for a "declaratory judgment" that the state is violating the Constitution's equal protection provision and that the Department of Social Services immediately move to raise the HUSKY C income limit to at least as high as the income limit for HUSKY D.