HARTFORD, CT – Legislators from both sides of the aisle pointed to the first part of a two-year study to conclude Medicaid is underfunded by the state, and some don’t want to wait for the second half in order to address the problem.
A study of Medicaid rates for various providers was originally commissioned in 2023, and the first part of the report found that Connecticut’s rates are lower than some of the surrounding states, which means providers of these services get less money for the services they provide to nearly 1 million Connecticut residents.
The study examined Medicaid reimbursement rates for over 11,000 specialized physicians, dental, and behavioral health services. Results indicate that Connecticut’s payments were below a benchmark set by peer states for 85% of the services analyzed and below a benchmark based on Medicare rates for 94% of the services analyzed.
Sen. Matt Lesser, D-Middletown, said Wednesday that the program has been underfunded for over 15 years, and that the $7 million that was earmarked to increase funding this year is “nowhere near enough.”
The fact that the program is still functioning, he said, is a miracle.
“If the program is a battleship, that’s not enough to build a canoe,” he said. Waiting for the second half of the study to be completed, which will be examining Medicaid reimbursements such as Federally Qualified Health Centers, is not something Lesser thinks is reasonable.
“If your house is on fire, you don’t wait to do a survey before you turn on the hose,” he said. Lesser said that he and others in the legislature want to address the problems shown in the first study as soon as possible.
That sentiment is shared by others in the Senate.
Sen. Jeff Gordon, R-Woodstock, said that the legislature has “known for years” that Medicaid is underfunded, and that waiting for the study won’t help much.
Gordon, who is a ranking member on the Public Health Committee and a medical doctor, said in a phone interview Tuesday that there are two main issues concerning the funding of the program.
Not only are healthcare professionals not being reimbursed enough, but ambulances are also not being funded properly. Gov. Ned Lamont’s budget adjustments removed a $5.36 million increase for ambulance and methadone maintenance providers that was included in the two-year budget adopted last year. An estimated 40% of emergency medical transportation are for patients with Medicaid.
According to Gordon, there are possible options for both short-term and long-term funding for Medicaid.
The legislature, Gordon said, could look into the budget that was approved for the Department of Social Services in order to find some reprieve for Medicaid in the short term. Since funding for DSS is already approved, money would not have to be taken out from under the spending cap, or by disregarding the fiscal guardrails.
ARPA is also an option, he said, and is something he is more than willing to discuss. However, he acknowledged it is hard to know how much is still available to be used and how strong the commitments are with ARPA money that was previously allocated.
Lesser, who co-chairs the Human Services Committee, said he is hesitant to move money around in social services. However , he said he is not opposed to working around the spending cap, and that counting mandatory programs like Medicaid against the spending cap would just be the state punishing itself.
Both said the key is finding a long-term, sustainable way to fund Medicaid.
Senate Republican Leadership said in a press release last month that they were not surprised by the findings, or by the fact that issues of Medicaid hit low-income and underserved communities the hardest.
“Republicans are engaged on this issue, working in a bipartisan way to find meaningful solutions for stakeholders and the public,” the statement read. “This is the serious challenge before us. The Appropriations, Human Services and Public Health committees are meeting. Republicans are involved actively in the debate and decision-making about how to pay for Medicaid services, not just in the short-term, but also in the long-term in responsible ways.”
Lesser said when the report was released that he was shocked at the depth of the problem.
“With rates frozen since 2007, I knew we had been underpaying Medicaid providers, but I am frankly stunned to find out just how big the problem is. While we of course will be at the table, this is beyond the ability of the legislature to fix on its own, and requires the Governor’s engagement,” Lesser said.
Lamont has made it clear that Medicaid will not be addressed until the second half of the study is completed next year.
Lesser said that he found the governor’s actions and remarks regarding Medicaid “a little tone deaf,” and that while he hopes that it can be a bipartisan issue in the legislature, problems can arise during discussions about funding.
