December 11, 2002
RE: GOVERNOR'S BUDGET PROPOSAL
Ellen Andrews, Executive Director, CT Health Policy Project
Thank you for this opportunity for input on the current state budget status and the Governor's proposals to address the deficit. Specifically, I would like to express grave concerns about both critical state employee layoffs and cuts to vital health services and coverage programs.
HUSKY enrollment, far from growing out of control, has seen modest increases over the last two years, as outlined in the attached policy brief. It has acted as designed, a safety net for children and families when the economy declined. As the recession threatens to deepen, freezing enrollments and eliminating eligible populations will fall hardest on those hardest hit by the economic downturn.
Recognizing that children's health cannot be separated from their parents', over recent years Connecticut has slowly expanded eligibility for HUSKY parents. This has become a critical support for thousands of Connecticut families, allowing many to leave the welfare roles for work. Since children and their parents do not have separate bank accounts, eliminating this support would harm both parents and their children.
Growth in spending for HUSKY has been modest over the last two years. Children and their parents are among the least expensive populations to cover. The federal government reimburses Connecticut for at least 50 cents for each dollar spent on Medicaid and HUSKY.
SAGA, as well, offers critical supports to Connecticut's poorest citizens who are left out of federally supported coverage programs. SAGA offers critical care to people with virtually no other options.
The Governor's proposal, if adopted, would create 35,000 to 40,000 new uninsured Connecticut residents, between elimination of coverage for SAGA and HUSKY parents. The numbers of uninsured in Connecticut are growing as unemployment rises, medical inflation remains in double digits, and more employers drop coverage for workers and dependents. The loss of these two critical coverage programs will not only cause significant hardships for the most vulnerable Connecticut residents, but will also cost the state far more in avoidable health costs.
The majority of Connecticut's uninsured are working adults just making ends meet. For most, either their employer does not offer health coverage or they are not eligible for the benefit. They are more likely to be single, young, minorities, and without a college degree.
The uninsured are more likely to delay accessing health care until a problem has grown more difficult (and more expensive) to treat. They are often forced into counterproductive coping strategies such as forgoing follow up provider visits, and rationing prescription medications.
The state has been offered several options to control costs in both HUSKY and SAGA, most notably Primary Care Case Management (PCCM), but has declined to even pilot the option. PCCM is used by most other states and has a long history of saving money, improving health care delivery and consumer and provider satisfaction.
HUSKY and SAGA have not been the problem in Connecticut's budget crisis, but rather a critical (and cost effective) protection. These critical programs should not bear the brunt of fixing the budget.
State employee layoffs have severely cut into vital state health and other services. There are alternatives to harsh program cuts and state employee layoffs. Comptroller Nancy Wyman has made a very reasonable and balanced proposal. While I understand that increasing taxes has economic consequences, it is hard to imagine that they could be as serious as 3000 more jobless and 40,000 more uninsured, as would result from adoption of the Governor's proposals. I urge you to consider the Comptroller's plan.