A group of Democratic state lawmakers said they are concerned about Sunday’s transition of more than 60,000 low-income Husky clients to two of the state’s newest managed care organizations.
The two new managed care organizations have been criticized for having little or no experience in Connecticut, which means fewer medical providers have signed up to participate in their plans.
“A Husky card without anyone to go to is a false promise,” Rep. Vickie Nardello, D-Prospect said.
Rep. David McCluskey, D-West Hartford, said he doesn’t understand why Gov. M. Jodi Rell’s administration will be forcing some of the state’s most vulnerable residents into two provider networks that have no track record in the state.
The Department of Social Services will automatically enroll more than 60,000 Husky clients into Aetna Better Health or AmeriChoice this Sunday.
Nardello said she doesn’t understand why they weren’t given the option to switch to Connecticut Health Networks, the third Husky insurance provider, which has been part of the Husky program since its inception.
“Community Health Network of CT is not part of the automatic assignment because it already has a comparatively substantial market share of enrollees—approx. 190,000 individuals in 76,000 households are in CHN,” the Department of Social Services spokesman David Dearborn said in a statement Friday afternoon.
“Even if automatically assigned a new plan, families can still choose a different plan after that at any time,” he stated.
“This population of people have been poked and prodded for years now,” McCluskey said. “We don’t see enough protections in place for these people.”
In the long term this potentially means the state will be spending more money on emergency room care, he said. “There’s a concern this population is just going to get ignored and end up in the emergency room with a much higher health acuity.”
Over the past few months, the state has encouraged Husky clients to research the three insurance companies participating in the Husky health insurance program and voluntarily transfer into one of them before the end of the day Friday.
As of Feb. 1 Anthem and traditional Medicaid will not be an option for Husky clients.
Democratic lawmakers are concerned the state is forcing the Husky clients into inadequate networks to get the Charter Oak program—Rell’s new health insurance program for uninsured adults—launched. Last January the two programs were put out to bid as one contract and until recently medical providers were required to sign up for both at the same time.
At the November Medicaid Managed Care Council meeting the Department of Social Services said, “DSS is combining the procurement to allow the successful bidders to balance the familiar risk and large size of the HUSKY enrollment with the less familiar and less predictable size of the Charter Oak enrollment.”
In recent months that part of the contract has been relaxed in an effort to beef up the number of doctors and hospitals participating in Husky.
Connecticut’s Congressional delegation has also not been pleased by what’s been going on with the Husky program.
In a press release the delegation said, “These managed care organizations threaten to disrupt and limit access to care for this vulnerable population because of inadequate provider networks.”
In this lettter to the federal Center for Medicare and Medicaid Services, the delegation wrote: “While we recognize that the state had made progress in enrolling providers and hospitals in the MCO provider networks by that point [the time of CMS’s approval], we are disturbed by reports that CMS may have overlooked network adequacy for specialists in approving the contracts. Specifically, at the January 9, 2009 monthly meeting of the Connecticut Medicaid Managed Care Council, a representative from the CMS Boston regional office implied that CMS had not conducted any analysis of whether the specialist networks of the new MCOs were adequate.”
Kimberly Primicerio contributed to this report
