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Approximately 60 senior citizens spent nearly two hours crowded into Newtown Senior Center on December 8. The group listened to State Senator Tony Hwang moderate a panel discussion that attempted to quell concerns surrounding proposed state budget cuts to the Medicare Savings Program (MSP). MSP is a Medicaid program designed to help Medicare recipients pay their premiums and health care cost sharing obligations.
According to a handout prepared by Connecticut Legal Services and shared on Friday, state budget cuts to MSP will impact approximately 113,000 low-income elderly and disabled Connecticut residents, which could consequently force many into emergency rooms and nursing facility care. In fiscal year 2016, the fiscal year for which the most recent information was available, 298 Newtown residents participated in MSP.
MSP’s eligibility limits were lowered with the passage of the $41.3 billion state budget in October. The new limits were to go into effect on January 1.
The state Department of Social Services (DSS) announced on December 6 that it will slow down implementation of the changes in response to concerns raised by enrollees, advocates, and legislators. DSS officials have said, according to The CT Mirror, that they will be reviewing coverage alternatives for current enrollees. The review will take two months, at which time the reduced limits are still expected to go into effect.
That is not good news for those who attended the special program last week. Initially announced as a program that would update area residents on the impact of recently passed legislation on taxes, Medicare health insurance, aging, and home care, all talk instead focused on the Medicare changes fast approaching.
Sen Hwang — who was joined by three representatives from the Western Connecticut Area Agency on Aging (WCAAA) and an attorney from Connecticut Legal Services for the panel, and State Representative Mitch Bolinsky in the audience — promised attendees answers in his opening statement.
“The real topic of this conversation is going to be to update you on some of the laws and legislation that was been passed, and what translates into your daily living,” Sen Hwang said Friday afternoon. Calling the recent legislative session “a real roller coaster ride,” he said the urgency of the December 8 Lunch & Learn program had been created “by a cut in our budget, to the Medicare Savings Eligibly Program, the supplemental program which the state provides.
“Of the $134 in your Social Security that you used to be able to keep, instead of it being deductible by the Social Security Administration to cover the Medicare program,” he continued, “the program cuts the eligibility from what was over 230-plus percent over the federal threshold to now 100 percent of the federal threshold.”
That means, he said, that a person must have an income of less than $13,000 a year in order to qualify. The previous range was approximately $24,000, he said.
“There is a whole array of services, as well as, most critically, your medical care, that is going to be impacted. If we did not update you on this today, there would be a tremendous shock to your well-being and to your pocketbook,” Sen Hwang said.
The senator pointed out that representatives from the DSS — who had sent out letters Rep Bolinsky later called “offensive” in that “they were designed to scare the bejesus out of you” — were not in attendance on Friday.
“I invited them on four different occasions,” he said, “including asking the commissioner, saying, ‘You, as an agency, whose sole responsibility is to administer this program, and to send out a notice to alarm people on this issue, you have a responsibility to come, and be a voice, and be able to be a resource, to update the community.’”
A Big Frustration
A lack of response from DSS, Sen Hwang said, has been one of his big frustrations during the process of updating his constituents.
“The very agency that should be focused on human services in the area of what they are supposed to deliver as a governmental service has forgotten the part about human,” he said. “They have forgotten that instead of just sending out bills and being bureaucratic, that they should come out, interact, and be a face, and be responsive to the people’s needs.”
Christina Fishbein, executive director of WCAAA, had been planning to begin the presentation with a brief background of MSP, and then questions from the audience would be answered by WCAAA staff members Margaly Bravo and Dolores Winans.
As Ms Fishbein was being introduced, however, Sen Hwang’s attention was drawn to Sanci Tenney, one of the attendees.
“She obviously has done some homework,” he said, referring to a stack of papers being tightly clenched in Ms Tenney’s fist. “I’m very anxious to hear from her, to be sure that we are listening and address any concerns that you have.”
Ms Tenney jumped at that opening. Her 97-year-old mother, she said, who needs a home health aide and is among those who “can least afford to take care of themselves.”
“These people built this country, and I don’t know if you voted Yes or No on this … but my mother was kicked out of the program by $2,” Ms Tenney said. “Her annual income is Social Security. Using her as an example — but there are many others — they get $1,000 or $1,200 per month for income to pay for their groceries, to pay for medical care, and to pay $2,000 or more for home health care, which is still cheaper than any I’ve considered.
“How do you reconcile that?” she challenged the senator. “We as a civilization, as a country, as an American, I’m ashamed.”
The senator told Ms Tenney that her mother was lucky to have her as an advocate, “and passionately caring for her.”
The budget process, he continued, “was complicated, but that is simply the tip of the iceberg. This cut was misplaced, and it was misunderstood, and I will blame all of us for not fully understanding the scope of it.”
His biggest frustration, he added, was that lawmakers were given guidance from DSS, “who said that this was something that was palatable.”
The changes have been announced, he said. “It’s a lesson learned,” he said.
“We are going to go back, and we are going to fix this,” he promised. “And we’re going to have an opportunity, with feedback from people like yourself, to do that. That’s why we’re here. I’d be remiss if I didn’t think people weren’t very happy about this.”
Next year lawmakers will again have difficult decisions, he said. In the meantime, he and those on the panel wanted to hear from the residents who had questions and concerns.
Unprecedented Public Response
Located in Waterbury, the Western Connecticut Area Agency on Aging is a social services agency for senior citizens, caregivers, and individuals with disabilities. Its executive director offered some sympathy for lawmakers when she first spoke on December 8.
“As a policy person and as a manager, I understand what they were up against,” said Christine Fishbein.
“Typically what happens in Hartford, and it’s happening in Washington, DC, with the federal budget, The Older Americans Act, which funds the meals — home delivered meals, congregate meals, and a lot of the services — that’s on the potential chopping block at the same time, so it’s a double whammy for us.”
While trying to not raise taxes or the national debt, she said, federal agencies often rely on state agencies to make up the difference when mandatory copays are expected for services. If a state program does not cover those copays, or an individual — like Ms Tenney’s mother — does not pay the copay, then they are kicked off MSP.
“On the other hand, the senior needs the income, the money, what we call ‘disposable income,’ to be able to pay the copay for the services,” Ms Fishbein said. “But they don’t have that understanding about how all these programs run.”
Ms Fishbein called the feedback she and legislators have been receiving since the announced cuts unprecedented to her.
“This is one of the most exciting fights I’ve ever been through,” she said. “You all, and the rest of the seniors in Connecticut, and persons with disabilities, are owed a big round of applause because we have never had a groundswell of letters, and calls,” she said, from people seeking to find out or tell someone how the change to MSP is going to impact their life.
Ms Fishbein said she can answer questions about benefits.
“If you give me a situation, we would be happy to put together services for you,” said Ms Fishbein.
Newtown resident Dolores Winans, a WCAAA board member, recently participated in a six-week intensive certified CHOICES course, Ms Fishbein said. A certified counselor on CHOICES — Connecticut’s program for Health insurance, Outreach, Information and Eligibility Screening, the official state health insurance program — Ms Winans is able to answer specific questions about benefits.
Magaly Bravo, who was also at the senior center on Friday afternoon, is the CHOICES director for WCAA. She too can answer questions about benefits, Ms Fishbein said.
Ms Bravo offered an outline of current costs including plan fees, deductibles, and copays, and prescription fees — the different plans offered by Medicare — and then briefly outlined what the new numbers will be.
“If you have questions, please contact us,” Ms Bravo said. “We will answer specifics. Not everyone will be affected by these cuts the same way. Talk to us — it’s going to be important for you to know the options you have.
“We are concerned and frustrated too,” she said. “We know the impact this is going to have on Medicare.”
Esther Rada, from the private nonprofit corporation Connecticut Legal Services, can offer residents information on options, Ms Fishbein said in her introduction of the panelists.
Ms Rada reinforced the idea of residents getting in touch with their elected officials.
“Contact your senator and your representative,” she said. “We still need a lot of action.
CSL has been active, she said, in fighting the cuts “from the first moment that they first came up on the horizon.” Connecticut can set the income and asset limits, which it has done, to great benefit for residents. The Connecticut levels have historically been more than 200 percent above the Federal Poverty Level.
Most states, she said, use the 100 percent Federal Poverty Level. The cuts recently adopted by the state drop the income and asset limits to the Federal Poverty Level, which is why so many residents are suddenly in limbo, trying to manage their health care options before March 1.
“So while we have this sense that we have this ride for a while to help very fragile, low-income seniors access this particular benefit, we want to save it,” she said. “But we can’t do that unless you keep calling, e-mailing, faxing, everything to your representatives, and your senators.
“And don’t just do it now,” she continued. “Do it until we have the program fixed. It’s going to be a real long fight.”
Sen Hwang encouraged everyone to e-mail their officials.
“Find out who your representatives and state senators are, and get in touch with them. Create that paper trail,” he said. “When you don’t hear back, send them another note and say ‘Hey, I e-mailed you back on this date. Why haven’t I heard back from you?’”
Questions on Friday covered problems or confusion with billing, pension funds and their assessments, private pay for health care, and even incorrect Explanation of Benefit forms many had received from their insurance companies, among others.
If there was an recurring statement on Friday from the presenters it was this: do your homework, and reach out for assistance and guidance sooner rather than later.
“It is important for us to hear from you,” Sen Hwang said. “It is important to share your stories, and your thoughts.”
A petition is being circulated, he said, from people who want their voices to be heard. Sen Hwang plans to hand deliver copies of the petitions to Governor Dannel Malloy and DSS Commissioner Roderick Bremby.
State Rep Bolinsky said he had heard from many people with fears they have about the changes to the Medicare Savings Program. He called the changes an oversight.
“It’s a priority of the Legislature, and it is bipartisan completely and totally,” he said. “This is something that actually was an oversight, and it is our plan to correct it. Please know that your best interests are always very, very high on our list of priorities and in our hearts.”
First Selectman Dan Rosenthal was also in attendance at Friday’s forum. Each official offered brief comments, but really allowed the panelists to respond to questions and comments.
Mr Rosenthal called the afternoon’s subject “something that is certainly concerning to everyone.” As with the others, he encouraged attendees to seek him out if they have questions.
“As first selectman, my door is always open,” said Mr Rosenthal, who was on his eighth day in office at that time. “Any concerns that you have that I can be of help with, please don’t hesitate to call my office or arrange a meeting. I want to help in any way that I can.”
While the state did not have DSS representatives on hand for the Lunch & Learn event, Newtown Director of Social Services Ann LoBosco and case worker Jacqueline Watson were both in attendance.
“We are also CHOICES certified,” Ms LoBosco reminded attendees. “We can answer questions, too.”
CT Mirror content was used for partial creation of this story. The Connecticut Mirror is an independent, nonprofit news organization covering government, politics, and public policy in the state.