In October of last year, Karen Healy lost her job. As a result, she also lost her Medicaid coverage because her social security income was, according to state law, too high.
HUSKY C, the state’s Medicaid program for people with disabilities, has very different income and asset limits for people who are working than for those who are not working. Many people with disabilities who retire or lose their jobs suddenly find themselves with too much money to continue qualifying for their Medicaid coverage, even though their income has decreased dramatically.
Individuals with disabilities who are working must make less than $75,000 annually and have assets of under $10,000 ($15,000 for a couple) to qualify. For non-working people with disabilities, the limits are even more severe. In most of the state, individuals must make less than $941 per month (roughly $11,300 annually) and have assets of under $1,600 to qualify for Medicaid.
While working, Healy’s income qualified her for Medicaid. She also qualified for Medicare, and she was able to get most of her major medical expenses covered under one program or the other.
But when Healy lost her job, even though she was bringing home much less money, her monthly social security payments — totaling around $1,695 — were too high for her to continue to qualify for Medicaid under the state’s non-working income limits.
“If you think of all the things I have to pay for, it’s not a lot,” Healy said of her social security income. “It leaves me with a couple hundred in leeway, even less, a month.”
Healy was left with only Medicare, which offers much less coverage than Medicaid, driving her monthly expenses up. She’s had to pay out-of-pocket for several medical services, including at-home visits from a nursing agency that cost her about $260 per month, which had been covered when she had Medicaid.
A bill that proposes raising the income and asset limits for Medicaid’s HUSKY C program passed through committee last week. The change would help residents with disabilities keep their Medicaid coverage in the event of a job loss or retirement.
“It would make it much easier to live,” said Healy of the legislation, adding, “And then the stress of [qualifying for Medicaid] is off because I know I’ll always have it. That’s a big thing.”
The current non-working income limit is set at 84% of the federal poverty level in most of the state. SB 283 would raise that limit to 138% of the federal poverty level. The bill would also raise the asset limits from the current levels of $1,600 for an individual and $2,400 for a couple to $5,000 for an individual and $7,500 for a couple.
Healy found a new job at the beginning of March and now qualifies for HUSKY C again, though she’s still in the process of getting her coverage reactivated with the Department of Social Services. She’s hoping her coverage is active by June, when she’s due to have a hip replacement, because Medicaid covers services like in-home and outpatient physical therapy, while Medicare does not.
“It makes people suffer,” said Healy of the current constraints of the program.
The income limits have also driven down participation in HUSKY C, explained Alison Weir, an attorney and policy advocate at Greater Hartford Legal Aid.
“The numbers keep going down of people enrolled in the program, not because there aren’t disabled people who need medical help but because the income eligibility has not kept up with the rate of poverty,” she said.
Increased eligibility for employees with disabilities
The bill would also completely eliminate Medicaid income and asset limits for working residents with disabilities.
Rick Famiglietti works at the Center for Disability Rights and receives health care through a combination of Medicaid for employees with disabilities, Medicare, and his employer-sponsored insurance.
Famiglietti said he’s currently saving less than he could to make sure he stays under the $10,000 asset limit for employees with disabilities for fear of losing his Medicaid coverage.
“What does that prevent me from doing as far as a limit? I can’t save for if I lose my job and I need six months to find another job. I won’t be able to save for maybe a nicer home.”
The bill originally introduced by the Human Services committee only addressed income and asset limits for working people with disabilities. But, during a public hearing, nearly everybody who spoke in support of the bill said that it should be expanded to also include increased limits for those who were not working.
“They’ve got this program to allow people to work while they’re disabled and keep their Medicaid, but there’s no program to keep Medicaid when I retire,” said Famiglietti.
Legislators amended the bill after the hearing, and the version that passed out of committee addresses both working and non-working limits. If it passes, supporters say, it would provide a much needed, major policy change.
“This would be huge,” said Weir of Greater Hartford Legal Aid.