Gov. Ned Lamont and other state officials spoke about the potential impact federal cuts to Medicaid will have on Connecticut residents on March 3 at Charter Oak Health Center in Hartford. A group of health centers filed a petition with the state seeking a boost in Medicaid reimbursement rates on March 10.
Connecticut’s poorest and sickest residents may soon be facing more obstacles to getting care, according to the community health centers charged with treating them.
Blaming decades of lagging reimbursements from the state, some health centers are scaling back services and bracing for more cuts as President Trump eyes reductions in federal Medicaid funding.
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Now the centers are taking on the state’s Department of Social Services, claiming that the formula used by the agency for reimbursements has left them with mounting losses. A group representing the centers filed a petition Tuesday with the agency in anticipation of a future lawsuit.
“We as health centers just can no longer afford to not get paid (for) appropriate costs when 60% of our patient base are actually Medicaid enrollees,” said Joanne Borduas, board chair of the Community Health Center Association of Connecticut. “We try to make it work, but it has become increasingly more difficult to do that when you're not compensated for the costs that you incur.”
The petition, formally known as a “declaratory ruling,” outlines the losses that Connecticut’s 17 federally qualified health centers say they sustain as a result of the state’s reimbursement rules. The state’s actions conflict with the mandate of the health centers and are “penny-wise and pound-foolish,” according to the petition.
In response to the filing, DSS spokesperson Christine Stuart said, “The department acknowledges receipt of the request and shall be analyzing and responding in due course and in compliance with statutes pertaining to petitions of state agencies for a declaratory ruling.”
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Connecticut’s Medicaid per-visit reimbursement rates are the lowest in the region, according to an analysis cited in the petition. The state’s rate comes in at $163.37 per visit, compared to $297 in New Hampshire, $241.96 in Massachusetts and $196.79 in Vermont.
The disparity in rates hits hardest for costly services like dental care, said Borduas, who also serves as CEO of Torrington’s Community Health & Wellness Center. After years of shortfalls, her center ended its dental treatments last month, services that were used by 1,400 of the center’s 6,700 total patients last year.
The Torrington center lost $350,000 on restorative dental procedures alone last year due the gap between costs and state reimbursements, Borduas said. As part of cutting dental services, the center laid off four staff members, she added.
Another center in Waterbury has also cut dental services this year, Borduas said, forcing poor patients in Northwest Connecticut to drive more than 40 minutes in some cases to reach dentists who accept Medicaid patients.
“We are all in the situation where we are looking seriously at what are we going to be able to afford to do,” Borduas said. “ Some of us will likely have to scale back services. Some will have to eliminate services.”
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In concert with the petition to DSS, the centers have mobilized to support a bill in the state Legislature that would raise Medicaid rates for a range of health-care providers.
Testifying before the Legislature’s Human Services Committee on Tuesday, Maggie Moffett of Fair Haven Community Health Care in New Haven spoke of increasingly frantic efforts to seek private funding “to fill the gaps left by insufficient Medicaid rates, funding that is never guaranteed and should never be expected to replace sustainable, predictable state support.”
Yvette Highsmith of Middletown’s Community Health Center warned of more reductions in services at locations including clinics at shelters and inside schools.
“We’re already seeing some cutbacks and layoffs that are happening at our health centers, and the future would require further reductions in order to access care if we stay on the current path,” Highsmith said.
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Actions on the state level come as all Connecticut providers anticipate changes coming from Washington, where President Trump has asked for $880 billion in cuts to Medicaid over the next decade, according to the Associated Press. More than 1.2 million Connecticut residents rely on Medicaid for health care, DSS Commissioner Andrea Barton Reeves said earlier this month.
A new analysis of the impact of Medicaid cuts on individual states by the Urban Institute looks at the potential impact of proposed rollbacks in Medicaid expansion, projecting a potential $80 billion decrease in overall federal healthcare spending nationwide in 2026.
Connecticut stands to lose more than $1 billion in Medicaid funds for the non-elderly in 2026, according to the analysis, for a decrease of 3.9% in overall healthcare spending — along with a $456 million revenue hit for hospitals in the state.
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Of our neighboring states, New York could lose $10 billion, for a decrease in healthcare spending of 7.1 percent, according to the Urban Institute, ranking it in the top 10 states for losses.
Connecticut health center leaders warned of the impact of federal cuts on their services, which were used by 440,000 patients last year at several hundred sites across the state, Bolduas said.
“We can’t know what’s going to happen, but we do know that there’s a freight train coming out of Washington and that we need Connecticut to support us now more than ever,” said Moffett of Fair Haven Community Health Care.
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