The Connecticut Health Exchange, known as Access Health CT (AHCT), is prepping for an uncertain future following the end of a federal government shutdown initiated by Democrats trying to preserve enhanced Affordable Care Act subsidies created under the American Rescue Plan Act that were set to expire at the end of the year.
The federal stalemate ended with an agreement that the Senate would consider a bill on the enhanced subsidies in December. The COVID era enhancements lowered health exchange plan premiums and extended assistance beyond 400 percent of the federal poverty level, but there is no guarantee of a vote in the House of Representatives.
During an AHCT board meeting on November 20, health exchange leaders indicated they are preparing for all scenarios in December. According to a presentation to the AHCT board, discussions at the federal level include extending the subsidies as they were, implementing a new cap on eligibility, new penalties for broker fraud, and new verification changes.
With open enrollment for 2026 running between November and January, AHCT reported more than 28,000 enrollees so far across all plans. Typically, the exchange sees well over 100,000 enrollees per year.
The presentation indicated AHCT expects to see auto-enrollment drop from its historical average of 86 percent of individuals to 73 percent due to those making in excess of 400 percent of the FPL no longer being eligible for enhanced credits or no longer qualifying for the plans.
AHCT is expecting an 8.2 percent decrease in the number of medical enrollees due to the federal changes, sliding from 158,557 in 2025 to 145,570 in 2026.
“Federal changes are reducing the amount of financial help and customers can expect to pay more for their coverage this year,” AHCT Chief Executive Officer James Michel said in an October 29 press release. “We encourage you to shop around for a plan this year.”
The press release and the board meeting both indicated it is possible the enhanced subsidies could be continued in December. If so, Michel indicated to the board, it would require AHCT to conduct new communications outreach to enrollees to encourage them to possibly change their plans, which would require additional spending.
“If they [Congress] extend them [enhanced subsidies] in December, the amount of communication we have to do goes up dramatically,” Michel said. “Folks who got their plans and paid their bill, we have to go back and look at them. Did they purchase down because the subsidy was a lot less than before?”
Access Health CT came in under budget for the 2025 fiscal year and is currently sitting on over $20 million in reserves, or enough money to carry the quasi-public agency for 5.8 months, according to the budget presentation. That is slightly below agency policy of maintaining six to nine months’ worth of reserves, although Michel said he expected to make that up through expenditure reductions and more grants.
While the policy update for AHCT spent much time focused on what will happen at the federal level, Director of Legal and Government Affairs Susan Rich-Bye also noted the recent special session called by Gov. Ned Lamont during which the General Assembly set aside $500 million in surplus revenue that can be used to fill in gaps should federal funding decrease for, among other things, health programs, which could include Medicaid or the exchange.
“Right now, we are focused on the immediate future, making sure we are prepared for what may happen in D.C. so we can pivot and make sure there is minimal disruption to our customers’ experience. We have a plan, we’re ready to go, we’re just waiting to see which direction it will go,” Michel said. “We look forward to that challenge.”
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