HUSKY Program Enrollment Dynamics: Coverage Continuity, Gaps in Coverage and Retention (April 2010)

Mary Alice Lee, Ph.D. & Joachim Hero, M.P.H.

Connecticut's success at reducing the numbers of uninsured children and families who are eligible for HUSKY but uninsured is dependent on two factors: how successful the state is at enrolling eligible children and families who are uninsured (take-up), and how well it keeps eligible children and families enrolled (retention). The scope of Connecticut's HUSKY retention problem is evident in the results of this study, which shows that among newly enrolled children and adults:

• Many new enrollees experienced gaps or lost HUSKY coverage in the first year. Despite having just been determined eligible, about one of every four new enrollees lost coverage in the first year, a disruption that undoubtedly affected access to needed care. Some of those who lost coverage re-enrolled within six months, suggesting that they may have been eligible during the gap in coverage.
• Many HUSKY enrollees experienced gaps or lost HUSKY coverage at renewal. Almost one in five who managed to stay enrolled for a year lost coverage at the time of they were to renew their coverage. This problem was particularly acute for children in HUSKY B (45% with a gap or loss of coverage). By 18 months after enrolling in the program, fully half the new enrollees had experienced a gap or lost coverage altogether. Many of those who lost coverage were probably eligible all along, since a large proportion returned to the program in six months or less.
• Retention rates varied across district offices. If policies and procedures for eligibility determination and renewal are not applied uniformly by workers in the district offices and enrollment broker, coverage continuity and retention may be affected by administrative errors and delays.

In order to reduce the number of uninsured children and families, Connecticut must take steps to keep eligible individuals enrolled and address the factors that contribute to loss of coverage, especially at the time of renewal. (April 2010)

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