State Getting $40M To Help Residents Access Health Care Coverage

HARTFORD — Connecticut recently received approval of an application that enables federal matching funds to support the state’s Covered Connecticut program. Currently in its second year, Covered Connecticut provides eligible individuals with free qualified health plan (QHP) coverage available through Access Health CT and free dental care and non-emergency medical transportation (NEMT) services through the HUSKY provider network.

“This federal funding will be instrumental in supporting our state’s actions to improve health equity and reduce health disparities by improving the affordability and accessibility of health care coverage,” Governor Ned Lamont said. “I thank CMS Administrator Chiquita Brooks-LaSure and the US Department of Health and Human Services for the favorable review of Connecticut’s application for the Covered Connecticut demonstration. I also thank the Biden administration and Connecticut’s Congressional delegation for championing enhanced qualified health plan premium subsidies.”

The federal Centers for Medicare and Medicaid Services (CMS) has approved Connecticut’s plan for expanded access to health insurance under a “Section 1115 demonstration waiver,” a key step that paves the way for federal matching funds program sustainability. The waiver will support the existing Covered Connecticut program that has expanded access to affordable health care by allowing eligible individuals to enroll in a no-cost silver-level QHP on the state marketplace.

The Covered Connecticut program requires use of federal premium subsidies and cost-sharing reductions while eliminating cost-sharing and out-of-pocket costs for enrollees.

The state will directly reimburse the insurance plan for the monthly premium and the cost-sharing amounts that the enrollee would normally have to pay after using all available federal supports, such as out-of-pocket costs for deductibles, copays, and coinsurance. Federal approval of the demonstration will enable the state to receive federal financial participation for the state’s costs of paying for the premiums, cost-sharing amounts, dental care, and NEMT services.

The waiver was sought on behalf of the Lamont administration by the Connecticut Department of Social Services with support and collaboration from the Connecticut Office of Health Strategy, the Connecticut Insurance Department, and Access Health Connecticut.

“The new Covered Connecticut program has already helped more 10,000 state residents get no-cost access to high-quality health care,” Department of Social Services Commissioner Deidre Gifford said. “With this support from our federal partners at CMS, we will be able to continue our work in closing health care coverage gaps and improving the health of our state residents.”

“Our mission at Access Health CT is to reduce Connecticut’s uninsured population and reduce health disparities,” James Michel, chief executive officer at Access Health CT, said. “Innovative approaches, such as the Covered Connecticut program, go a long way in helping us achieve these mission-driven goals. And more importantly, the federal funding approved to continue the Covered Connecticut program will have a significant, positive impact on the health and wellness of Connecticut residents who qualify for no-cost health care, dental, and non-emergency medical transportation benefits. We are thankful for the continued financial support making this program possible today and into the future.

The Covered Connecticut 1115 waiver demonstration will provide approximately $40 million in annual federal matching funds to help sustain efforts to expand access to health insurance for eligible Connecticut residents who are not eligible for Medicaid but struggle to pay cost sharing and other out-of-pocket health-related expenses. It is funded through December 31, 2027.

Over the past several years, Connecticut has had a growing health insurance affordability gap. In 2018, individuals with incomes between 100 and 200 percent of the federal poverty level (FPL) made up 13 percent of Connecticut’s population but 26 percent of its uninsured residents. Approximately 48,000 people in this income range were uninsured, which was an increase from 36,300 people in this income range who were uninsured in 2016. The Covered Connecticut waiver demonstration project will help close this gap by offering no-cost coverage for individuals with incomes up to 175 percent of FPL who cannot qualify for Medicaid.

To enroll or learn more about coverage options, visit accesshealthct.com or call 1-855-805-4325 to receive free assistance from an Access Health CT representative.