Patricia Baker, president and CEO of the Connecticut Health Foundation, released the following statement in response to the Graham-Cassidy health care amendment currently being considered by the U.S. Senate:
The Senate proposal would reverse the major gains Connecticut has made in reducing the uninsured rate and would threaten critical protections people with private coverage now count on.
Connecticut would be hit especially hard by the funding cuts in the proposal, according to multiple analyses, leaving the state with substantially less money to provide health care coverage to low-income children and adults and people with disabilities. The thousands of Connecticut residents who receive financial assistance to buy coverage on their own would likely face cuts in this aid or lose it entirely. People with pre-existing conditions could once again face higher prices to buy coverage.
The proposal would also fundamentally change the nature of the Medicaid program. Under this proposal, Connecticut would likely be forced to make significant cuts to the program or raise taxes substantially to maintain coverage for those who need it.
Although proponents have described Graham-Cassidy as a way to give flexibility to states, the reduction in federal health care funding means Connecticut would be left with few choices except what to cut – whether to cut people off Medicaid, pay doctors and hospitals less for treating patients, or cut back the care people in the program can receive.
There are big problems in the U.S. health care system, but this proposal would not fix any of them. Instead, reversing the gains in coverage and access brought by the Affordable Care Act would set back efforts to make care and coverage more affordable, eliminate health disparities, and improve care quality.
Members of Congress recently began a bipartisan process to identify real solutions to the challenges we face in health care. This process should be allowed to continue.
Details on the impact on Connecticut
Three major changes in the Graham-Cassidy proposal would have dramatic effects on Connecticut. They are:
Eliminating the Medicaid expansion and financial assistance to buy private insurance created by the Affordable Care Act. The proposal would instead give states a set amount of money to use to provide coverage, but for many states, including Connecticut, that sum would be substantially less than what they would receive under current law.
Changing the way Medicaid functions. Currently, Medicaid provides coverage to anyone who qualifies, and states receive federal reimbursement for that coverage based on what it costs. Under the Graham-Cassidy proposal, states would instead receive a fixed amount of money to provide coverage, regardless of how much it costs. This is projected to reduce the amount of federal money states receive to provide Medicaid coverage. It would not make care cost less, but provide less money for states to pay for it.
Allowing states to roll back consumer protections for people covered by private insurance. This could result in health plans that do not cover essential health benefits, plans that require people with pre-existing conditions to pay more for coverage, and the reintroduction of coverage limits, which left people who faced high medical costs – such as for cancer treatment, care following a car accident, or treatment for a costly chronic disease – with huge medical bills.
What it could cost Connecticut?
Connecticut currently covers more than 200,000 low-income adults without minor children through the HUSKY D Medicaid program. The federal government pays 95 percent of the cost of their coverage. These adults were ineligible for Medicaid before the Affordable Care Act.
Separately, approximately 72,000 Connecticut residents who purchase their own insurance receive federal tax credits that discount the cost of their premiums.
Under the Graham-Cassidy proposal, this funding would be dramatically reduced and potentially eliminated after 2026. Multiple analyses indicate that Connecticut would see steep cuts.
According to an analysis by the consulting firm Manatt Health, Connecticut would, in 2026, face a 47 percent cut in federal funding for HUSKY D and individual-market premium assistance compared to current law. (Under current law, the federal government would provide $2.8 billion for coverage of these Connecticut residents in 2026. Under the proposal, that would drop to $1.49 billion.)
A separate analysis by the consulting firm Avalere projects that Connecticut would see a $10 billion reduction in federal funding from 2020 to 2026, a 16 percent cut. This takes into account both funding for HUSKY D and the individual-market subsidies, as well as funding for the rest of the Medicaid program.
These estimates vary in part because they cover different years and types of spending, and in part because the proposal contains uncertainties about how money would be allocated. These uncertainties make it more concerning that the Graham-Cassidy proposal could pass without time for a full analysis by the Congressional Budget Office and robust debate based on an understanding of the complex changes the bill would set in motion.
The Connecticut Health Foundation (CT Health) is the state’s largest independent health philanthropy dedicated to improving lives by changing health systems. Since it was established in 1999, the foundation has supported innovative grantmaking, public policy research technical assistance and convening to achieve its mission – to improve the health of the people of Connecticut. Over the past 17 years, CT Health has awarded grants totaling more than $59 million in 45 cities and towns throughout the state.
For more information about the foundation, please visit www.cthealth.org or call 860.724.1580