Access Health CT is “preparing for the worst,” according to CEO James Michel.
At the most recent Access Health Board of Directors’ meeting on Sept. 18, Michel said that they expect the 2021 Affordable Care Act (ACA) tax credits to expire at the end of the year. If these credits are not renewed, 30% to 35% of Access Health customers will be uninsured by 2034.
“We’ve been working closely with my colleagues across the country to advocate for their extension. Some stuff is happening behind the scenes,” Michels said. “But right now we are planning as if they are not going to extend.”
Presently, there are 150,000 people enrolled in a qualified health program from Access Health.
Around 28,000 of those people have a household income more than 400% of the federal poverty level (FPL), which means that they will no longer be eligible for any financial support if the tax credits lapse. An additional 5,300 people who have a household income level of less than 100% of the FPL will lose coverage for other reasons, including immigration status.
He expects the rest of the projected losses will occur slowly.
“Over the years, there will be a gradual decline towards that (30-35%) number,” Michel said at the meeting. “Some folks will go through a process as it becomes more expensive for them… and they (will) just sort of gradually drop off.”
These estimates are based on the method used to calculate financial assistance for health insurance premiums under the ACA prior to the pandemic tax credits, which introduced temporary enhancements.
There isn’t enough data to predict a year-by-year breakdown of the pace at which this happens, Michel said. They also can’t predict the demographics of the people who will drop off.
“Health insurance [costs] will rise significantly for the remaining customers,” Michels said.
Access Health Board of Directors member Claudio Gualtieri, who is a senior policy advisor at Connecticut’s Office of Policy and Management (OPM), speculated that people who are healthier and utilize less health insurance will probably leave the program, while people who use their health insurance plans more are more likely to remain.
“I suspect, if someone really is going to be a high utilizer and needs it, the value proposition for paying whatever the price is, even if it goes up, may be different than someone who is relatively healthy,” Gualtieri said.
However, Michel said that Access Health leadership could not draw that conclusion.
“We don’t have any information to assess which group of the high users, of claims, of medical services, to try to assess who’s going to stay, who’s going to leave,” Michel said.
Every year, Access Health runs a “leaver survey” which asks people who were previously enrolled in Access Health why they did not renew their plans. That survey will be conducted during the open enrollment period, and the information will be available after it ends.
Open enrollment for Access Health begins on Nov. 1, and will continue until Jan. 15, 2026.
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