Rep. Toni Walker didn’t mince words Tuesday when she told representatives of the Department of Social Services they overstepped their bounds when they sent letters to low-income individuals on Medicaid warning them of changes the legislature had yet to approve.
The letters detailed the changes to the Low-Income Adult, or LIA, program and warned about 77,000 individuals they may lose their health insurance because they may no longer qualify for the program.
The letter, mailed four days before the June 12 special session, was based on the department’s assumption that the waiver, which includes an asset test, would pass in the special session, Walker said.
“Do not assume that we will not overturn this,” Walker told DSS Deputy Commissioner Kathleen Brennan.
“The fact that we’re in the process of doing a waiver and we created panic in a population that’s already fragile is a major problem,” Walker said.
But the letter was not intended to create panic, according to Brennan. Its purpose was to give people a chance to look for other health care opportunities, if in fact the waiver moves forward, she said.
In terms of moving forward, Brennan said she intended to constructively take comments and concerns voiced in Tuesday’s hearing and use them to create a more complete plan of action. She did not anticipate so many questions that she was not prepared or able to answer.
Walker said Department of Social Services Commissioner Roderick Bremby, who did not attend the hearing, should be informed that assumptions will not be tolerated.
“The legislature does not like being put in a position where there’s an assumption that things are going to happen before we go through the process. That negates us as being part of the conversation. And it negates the community from being part of the conversation,” she said.
The waiver includes a $10,000 asset test, which says if you can be claimed as a dependent on your parent’s tax return then they will count your parents’ income and assets as if they are yours. It also limits the stay at a nursing home to 90 days. Currently, there is no limit on nursing home stays.
The waiver has to be approved by the legislature’s Appropriations and Human Services Committees before it’s submitted to the Centers for Medicaid and Medicare Services, which is the federal body that has the authority to ultimately grant the waiver.
If Walker has her way, the July 24 hearing will answer all remaining questions from both the legislature and the public.
Advocates and caregivers who attended the hearing all expressed their opposition to the waiver, which they said would kick needy individuals off the state-funded health insurance.
“It is hard to swallow the potential of this proposal to terminate coverage for thousands, 15,000-20,000, people at a time when many, if not most of them, will be unable to afford or find other coverage,” State Healthcare Advocate Victoria Veltri said.
The Malloy administration initially suggested imposing a $25,000 asset test even though they admitted it was unclear how many people may lose coverage because of the move, but it estimated it would save the state about $25 million. Faced with a budget deficit at the end of the year, the legislature agreed to a $10,000 asset test when it approved the budget in May.
Sheldon Toubman, a New Haven Legal Aid attorney who filed the class action lawsuit against DSS earlier this year for its inability to process Medicaid applications, vehemently opposed the asset test.
“Counting parental income for adults, even young adults, is a radical departure from established Medicaid policy,” Toubman said. “DSS offers no explanation for how it will determine whether parents have health insurance themselves, can cover their adult children under their plan and can afford coverage for those children, if it is so offered.”
He said it also doesn’t make sense for the state to move in this direction now because in 2014 LIA will be 100 percent federally funded.
“Making changes now will cause unnecessary confusion and disruption in health care for low-income people, for such a short period of potential savings,” Toubman said.
He said the department’s proposal also assumes it has enough staff to handle the increased caseloads that come with asking people to re-apply for the program.
Dianne Olson, the mother of a brain-injured adult son, is all too familiar with the department notifying her that her son will be kicked off their plan.
“This has happened at least thirty times to my son in the last 25 years that he has been with DSS,” she said. “I must drive to DSS, hand them the envelope, get it date stamped and have them copy the envelope and give me that as a receipt. What do all the clients do who cannot drive to DSS? How many get dropped for no reason?”
At an unrelated press conference, Gov. Dannel Malloy stressed that the program was not designed to cover the expenses of a college student’s health insurance plan, nor was it designed for people who have substantial assets.
Enrollment in the program has exceeded expectations, due mostly to a poor economy, and as a result the amount the state must contribute has increased.
“I’m not criticizing the legislature, in fact I’m holding them to their expectation and estimates,” he said.