Melissa Bailey photo

Taking a play straight from former Gov. John Rowland’s playbook, Rell proposed raising a total of $18 million over the next two years by charging low-income adults monthly premiums and co-pays for the state’s Husky insurance program.

The proposed premiums would be applied on a sliding scale and could equal from 10 to 20 percent of the cost of services provided. The proposal received no mention in her budget address Wednesday, but was included in the 782-page document.

When asked if this was a tax increase on some of the state’s most vulnerable residents, Rell’s Budget Director Robert Genuario, said “No, not at all.” He said the poorest of the groups would still be exempt from that co-pay and for those being asked to pay “it’s a payment for service.”

Connecticut now charges families earning less than 185 percent of the federal poverty level no monthly premium to participate in Husky. Those above 185 percent of the federal poverty level must pay a premium. Premiums for those on the Husky B plan also will increase, and only emergency dental services will be offered to adults on Medicaid and Saga.

Children under the age of 18 and individuals at or below 100 percent of the federal poverty level won’t be asked to participate in the cost sharing, Genuario said.

State Healthcare Advocate Kevin Lembo said in a phone interview Wednesday night that he was still analyzing the proposal, but in general cost sharing is an obstacle for getting health care to the poor. He said the savings are not realized in the dollars received as part of the cost sharing, but in the direct care that people receive.

“Cost sharing just puts an obstacle in the way,” Lembo said.

Congresswoman Rosa DeLauro even weighed in on the issue. In a statement released Wednesday night, DeLauro said, “It is unfortunate and disappointing that on the same day as we celebrate President Obama’s signing into law the Children’s Health Insurance Program Reauthorization, Governor Rell proposed a budget that would cut back some of the very health care services that Congress fought so hard to preserve and expand.”

“There is no question that given the extremely dire budget circumstances facing Connecticut, balancing the budget is no easy task,” DeLauro said. “But now is not the time to balance the state’s budget on the backs of low and middle-income Connecticut residents – many of whom are children.  Ultimately, efforts to expand health care coverage will hold little value for our nation’s children and families if access to care continues to erode, whether by chipping away at benefits or increasing co-pays and deductibles.”

Connecticut Voices for Children agrees.

In the statement sent out Wednesday night the policy organization said, “Cuts to HUSKY are penny wise and pound foolish, particularly in this environment. Preventive care through HUSKY can help reduce costs for the entire health care system.”

In addition to the Husky cost sharing, Rell proposed eliminating the Office of the Healthcare Advocate, whose staff has been vocal about their opposition to the combination of the Husky program with her new Charter Oak Health Plan for uninsured adults.

When asked if he thought it was retribution for the opposition, Lembo said, “I can’t believe it would be retribution.”

“At best it was a misinformed attempt to trim,” he said.

The Office of the State Healthcare Advocate is an independent state agency which helps consumers resolve health insurance issues. It receives its operating expenses from the Insurance Fund, which is a levy on insurance companies to pay for their own regulation and for the consumer advocate.

He said by eliminating the office all Rell’s administration is doing is giving a credit back to the insurance industry. He said last year with a budget of $1 million and seven employees, he was able to help more than 2,000 consumers save $5.2 million in claims.

Since Jan. 1, 2005 the office has helped about 7,500 consumers save $14 million in claims.

“Not only do we have a business model that’s efficient, it’s one that’s being exported across the country,” Lembo said.

Juan Figueroa, president of the Universal Healthcare Foundation said, ” In addition to proposing short-sighted cuts to the state’s health care safety net responsible for our state’s most vulnerable residents, the governor’s budget calls for the elimination of the Office of the Healthcare Advocate.  This would deal a devastating blow to consumers at a time when advocacy on their behalf is most urgently needed.”