Two legislative committees will allow Gov. Dannel P. Malloy’s administration to submit a waiver application to the Centers for Medicaid and Medicare Services, which may kick as many as 13,000 low-income adults off their health insurance by January.
The Appropriations and Human Services Committees decided to let the Malloy administration move forward with the waiver to change the eligibility standards for the Low-Income Adult Medicaid program without a vote. Following a meeting in July it became apparent that there were still too many open ended questions about whether the Department of Social Services had enough staff to determine whether an individual qualified or re-qualified for the program.
Instead of bucking the governor’s administration, at the same time as blowing a $50 million hole in the budget, Rep. Toni Walker, D-New Haven, said they decided to let the administration proceed.
“It was an amount that was already accounted for and voted on in the budget,” Walker, co-chairwoman of the Appropriations Committee, said Tuesday.
When the General Assembly adopted the budget language on June 12 the waiver was included as a way to help them achieve the necessary savings.
The administration proposed the waiver because it was concerned about skyrocketing enrollment and, more specifically, about the number of college-age children in the program. According to DSS, there are 20,354 enrollees under the age of 26 in the LIA program. The waiver seeks to apply a $10,000 asset test to those applying for the program. The new asset test would apply to the families of these children, ages 19 to 26, and it would likely kick many of them off the program.
Sheldon Toubman, a New Haven legal aid attorney, said he finds it hard to believe any of those enrolled in the LIA program have $10,000 in assets, if they’re living at 55 percent of the federal poverty level.
“They’re going to be lucky to find one,” Toubman said.
In a July 24 letter to Rep. Peter Tercyak, DSS Commissioner Roderick Bremby estimated that 8,293 individuals have $10,000 or more in assets, not including their home and their vehicle.
But since there has never been an asset test imposed on the population there’s no data by which to draw any sort of firm conclusion.
“The specific information related to LIA members who have liquid assets in excess of $10,000 was not available during the development of the waiver estimates,” Bremby wrote.
Aside from not knowing how many individuals the waiver would impact if it was approved there’s also the $50 million in estimated savings already built into the fiscal year 2013 budget.
“There’s going to be a hole in the budget either way because the numbers are made up,” Toubman said.
Walker didn’t necessarily disagree, but she offered a solution to the problem Toubman predicted.
She said there are states not taking advantage of the Affordable Care Act’s Medicaid expansion and Connecticut may be able to access a higher reimbursement rate for its Medicaid population as a result.
As a member of the Medicaid Council and former chair of the Human Services Committee, Walker said the Centers for Medicaid and Medicare Services, “do not generally like asset tests.”
She said especially considering the federal government through the Affordable Care Act will be paying for 100 percent of the costs for this population starting in 2014. Currently, the state receives 50 percent reimbursement from the federal government and before the Affordable Care Act it received no federal reimbursement.
“I think the governor’s office is just trying to get people to look at their waiver and see if there’s anything they can do,” Walker said. “But I’m skeptical.”
Kate Mattias, executive director of the National Alliance on Mental Illness, was also skeptical the state would be able to get the waiver approved.
“I don’t think they that they will approve it,” Mattias said. “They will be reluctant to change it for what amounts to a year.”
David Dearborn, a spokesman with the Department of Social Services, said the waiver will be submitted after Aug. 18 and the department is “confident CMS will consider Connecticut’s waiver application with its usual thoroughness and professionalism.”
Meanwhile, Mattias said she’s concerned about the disruption in service for her members because this program is the only way many of them can get their medications.
She said DSS is already backlogged and asking for more information from clients to determine eligibility will only make things worse.
In 2002 there were 845 eligibility workers in DSS, but in January 2012 it was down to 558.
Dearborn said currently the department has “more than 700 staff in eligibility services,” and has approval to hire 100 more.
A class action lawsuit filed against DSS for its inability to process Medicaid applications in a timely manner is still pending.
More than 35 individuals came to testify on July 24 about their inability to get the department to approve the redetermination of services on their first attempt.
Click here to read a sampling of their testimony.