In good news, U.S. Census data finds that Connecticut’s uninsured rate continues to drop. Last year 4.9 percent of Connecticut residents didn’t have coverage. While that’s still 179,000 people and far too high, it is down by almost half from 2013. The bad news is that all that progress is at risk with a vote in Congress next week. Despite what you’ve heard, efforts to repeal and replace the Affordable Care Act and slash Medicaid are alive and well.
The new Census data holds several important lessons. Connecticut is very fortunate that our uninsured rate is lower than most states and, like the rest of the country, we benefitted from the Affordable Care Act. But the stronger message is that the recession that began in 2008, and cost Connecticut 119,000 jobs, had a bigger impact than the Affordable Care Act.
There is no evidence that the Affordable Care Act has reduced employer-sponsored coverage in Connecticut. Residents of our state remain more likely to have employer coverage than other Americans. Employer sponsored coverage has declined since the implementation of Affordable Care Act expansions in 2014, but that rate had been declining for many years. During the recession, from 2008 through 2013, Connecticut residents lost employer-sponsored coverage at seven times the annual rate since the Affordable Care Act expansions began.
Connecticut’s Medicaid rolls, a significant part of the expansions, grew about as fast during the recession — likely due to people losing jobs — as they did with the Affordable Care Act expansion. Connecticut is only recently approaching the national percent of the population covered by Medicaid, and that includes the nineteen states that chose not to expand eligibility.
The bad news is that all this progress is at risk. Out of the ashes of the last failed Congressional attempt to repeal the Affordable Care Act, four Senators have developed an even worse proposal. Doctors, hospitals, insurers, consumer groups, as well as a growing group of Democratic and Republican Governors oppose the bill. Despite that, they are very close to the 50 Senate votes they need to pass it by a procedural deadline at the end of the month. House leaders have already said they will pass it and the President plans to sign it.
The proposal, the Cassidy-Grassley plan, places drastic state caps on not only Medicaid but also on insurance subsidies in the Obamacare marketplaces. The caps include no provisions for disasters like hurricanes, the opioid epidemic, or recessions. It ends funding for the Medicaid expansion that has covered over 100,000 Connecticut residents. The bill guts insurance protections for people with pre-existing conditions, destabilizes already fragile insurance markets, and will cause more people to become uninsured than any of the previous failed repeal proposals.
The Congressional Budget Office won’t have official predictions of the costs to states, numbers of people who will become uninsured, or impact on insurance premiums by the time of the vote. But experts estimate that under Cassidy-Grassley Connecticut would lose $10 billion between 2020 and 2026, the third most severe cut among states, and $77 billion by 2036. Our state budget is already billions in deficit; there is no possible way to absorb these costs without massive harm and increases in the uninsured rate.
Connecticut residents and our state budget are far healthier because of the Affordable Care Act. If Congress repeals it, we won’t recover.
Ellen Andrews, PhD, is the executive director of the CT Health Policy Project. Follow her on Twitter @CTHealthNotes.
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