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CT is Bringing Health Insurance to More Children and Families
 

CT is Bringing Health Insurance to More Children and Families

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Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Author: Kristin Dowty

Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Author: Kristin Dowty

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    CT is Bringing Health Insurance to More Children and Families CT is Bringing Health Insurance to More Children and Families Presentation Transcript

    • CT is bringing health insurance to more children and families “ My goal is to make sure that every adult and child in Connecticut has access to health insurance.” - Governor M. Jodi Rell (12/26/06)
    • HUSKY – 10 years strong
      • October 1997 - historic legislation signed HUSKY into law with the support of every member of the General Assembly
      • 2007 – Continued commitment
        • Encourage renewal of existing families
        • Reach out to new families who are eligible
        • Expand programs to cover more individuals and families
    • CT’s health care picture today
      • Approximately 222,000 residents have no health insurance. [OHCA data, 2006]
      • Although CT has large populations covered by public assistance programs, many are too old for HUSKY, too young for Medicare, and not eligible for Medicaid or SAGA.
          • HUSKY A & B - 310,000
          • Medicaid FFS – 88,600
          • Medicare – 600,000
          • SAGA – 32,300
    • Changes in the health insurance environment
      • CT Changes between 2004 – 2006
        • Employment based coverage increased from 64% to 66.5%
        • Public coverage declined from 26.2% to 23.3%
        • Number of uninsured grew slightly from 5.8% to 6.4%
    • Connecticut’s uninsured
      • 66% of uninsured families have incomes under 300% of the FPL
      • 53% of the uninsured are under age 40
      • 55% of the uninsured are minorities with Hispanics comprising 34%
      • 66% of the uninsured are single or living with a partner
    • Connecticut’s uninsured
      • 61% of the uninsured are working adults
      • 49% of the uninsured work for employers with less than 25 employees
      • 57% of “Mom & Pop” employers (<10 employees) do not offer insurance
      • 25% of the uninsured may meet the current Medicaid, HUSKY or Medicare eligibility requirements
    • HUSKY A – Medicaid managed care
      • Children to 185% FPL
      • Parents/Caretakers to 185% FPL
      • 19 & 20 year olds up to MNIL
      • Pregnant Women to 185% FPL (soon to be 250% FPL)
      • 1 year TMA
      • Rich benefit package
      • No cost to clients
      • Children up to age 19
      • Enrollment as of 9/07- 209,544 children & 93,523 adults
    • HUSKY B – SCHIP managed care
      • All children covered regardless of income
        • 186% - 235% FPL, small co-pays, no premiums
        • 236% - 300% FPL, small co-pays, $30/$50 monthly premium
        • 300% FPL, small co-pays, full premium to $222 monthly
      • Children up to age 19
      • Comprehensive benefit package modeled after State employees benefit package
      • Enrollment as of 9/07 – 16,865 children
    • New initiatives to enroll children
      • HUSKY Health 2007 Initiatives
        • Local and statewide HUSKY outreach
        • Enrollment and retention of school-age children
        • Coverage for uninsured newborns
    • Local and Statewide HUSKY Outreach
      • $1.1 million grants for outreach contracts
        • Community-based outreach (5)
        • Regional outreach (2)
        • Statewide outreach (1)
        • Statutorily defined “Priority School Districts” (15)
        • State Department of Education’s 6 Regional Educational Service Centers
    • Local and Statewide HUSKY Outreach
      • Outreach strategies for enrollment and retention
        • Door to door; person to person
        • Telephone contact with follow-up
        • Local media - radio, TV, newspapers, posters, web-sites
        • Seminars/presentations, multi-lingual
        • Employers with low-wage workers, health clinics, community centers, faith-based organizations, job centers, town social service offices
    • Enrollment & retention of school-age children
      • Priority School Districts
        • Collect & track student insurance information
        • Provide HUSKY information and application assistance to families of uninsured students
        • Follow-up with families
      • SDE’s Regional Educational Service Centers
        • Implement training program to provide education on the HUSKY program to school professionals including social workers, nurses, counselors and teachers
    • HUSKY Outreach Evaluation
      • Process Measures, self-reported by contractors:
        • # of presentations and materials distributed
        • # of families and children reached
        • # of application and renewal assistance
        • # of unsuccessful efforts and reasons why (e.g. undocumented)
    • HUSKY Outreach Outcome Measures
      • Applications & Renewals – tracked by ACS and DSS
        • # of submitted applications
        • # of successful applications
        • Increase in % of returned renewals
        • Increase in % of successful renewals
      • Increase in overall enrollment
      • Anecdotal/Qualitative
        • Feedback from Consumers
    • Covering uninsured newborns
      • Cover all uninsured newborns born in CT hospitals or participating border hospitals
      • Partner with CT & border hospitals for notification
      • Expedite eligibility determination of all uninsured newborns
      • DSS will pay the first 4 month’s premium, if required
    • Other new initiatives
      • Pregnant woman expansion
      • Family planning program
      • Primary Care Case Management Pilot
      • Premium Assistance for ESI
      • Charter Oak Health Plan
    • Pregnant woman expansion
      • Cover pregnant women to 250% FPL
      • Full Medicaid benefit package including transportation
      • No out-of-pocket costs
      • Newborns automatically deemed eligible for 1 year
    • Family Planning Program
      • Increase availability of effective contraceptive methods
      • Decrease the number of unintended or mistimed pregnancies
      • Increase the spacing between pregnancies
      • Increase access to primary care
    • Family Planning Program
      • Family income to 185% FPL, ineligible for Medicaid
      • No asset test
      • Females - ages 14 – 55
      • Males – ages 14 – 60
      • US Citizen or qualified immigrant
    • Family Planning Program
      • Family planning services
        • including annual physical exam
        • diagnostic and laboratory testing
        • immunizations
        • treatment of STDs
        • medications required incidental to family planning procedures
        • contraception management including devices, prescription and non-prescription contraceptives
        • tubal ligation and vasectomy
    • Primary Care Case Management
      • Pilot program
      • May attract more provider participation
        • PCPs work with one entity, rather than 4 MCOs
        • FFS reimbursement plus PMPM fee for care management
      • Integrated disease management program
    • Premium Assistance Program
      • Promotes family coverage
        • Required to enroll self & dependents if insurance is available and meets certain conditions
      • For employed HUSKY A clients
      • DSS accountable for premium contribution, deductibles, co-payments and full Medicaid wrap around coverage
    • Charter Oak Health Plan – covering uninsured adults
      • Coverage through a private model
      • No asset test
      • No pre-existing conditions
      • No individual or employer mandate
      • Participation is voluntary
      • Payments from members to MCOs
      • Payments from members to MCOs
      • Deductible - $1000 max
      • State investment is premium subsidies on a sliding scale – up to 300% FPL
      • $1 million lifetime benefit max
      • 6 month crowd-out
    • For more information Kristin R. Dowty, HUSKY Program Phone: 860-424-4805 Email: [email_address]