In Connecticut, babies who are enrolled in HUSKY A (Medicaid) are at risk of losing coverage when they turn one. That birthday prompts a review of the infant’s eligibility. The timing, notices, and review process can be confusing for families. For example, the HUSKY program notice informs families that the child is no longer eligible for coverage because “you are not the right age to be eligible for this program.” Loss of coverage for one-year olds is a long-standing problem that can disrupt access to needed health care for very young children.
This analysis of enrollment trends in the HUSKY program finds that in 2008-2009, babies in the Medicaid coverage group for newborns were most at risk for losing coverage: over 40 percent were not enrolled in the month following their first birthdays. This finding suggests that the timing, notices, and renewal processes associated with the Medicaid coverage group for newborns affect continuing enrollment. In comparison, the disenrollment rates are far lower for 5 and 10 year olds (2.3% and 2.0%) whose birthdays do not prompt an eligibility review.
In order to address the problem, we recommend that the Department of Social Services revise notices and procedures for alerting families with children turning one; develop and implement procedures for continuing coverage of one year olds in all cases where other family members are enrolled and in all other cases until the eligibility review is complete; and develop and implement automated procedures and staff training to ensure that eligible infants do not lose coverage when they turn one. We also recommend that community-based HUSKY outreach workers should identify families with babies who are at risk for losing coverage and reach out to their families with information about how to avoid gaps in coverage or disenrollment.