Health advocates across the state brace for fallout from Medicaid cuts

Between 100,000 and 200,000 Connecticut residents could lose health insurance coverage from HUSKY Health, the state’s Medicaid program, over the coming years, severely impacting seniors, healthcare and eldercare facilities, particularly in rural communities.

That assessment from state Comptroller Sean Scanlon, which would impact an estimated one in five people, came on the heels of the passage of H.R.1, the One Big Beautiful Bill Act (OBBBA), signed into law on July 4.

On July 22, Scanlon released a “Special Examination” on the piece of legislation to aid businesses, individuals and families with information on how it will impact them and their lives in the months and years to come.

Included in the comptroller’s 36-page report is a section on Medicaid, in which the state comptroller outlined expected negative impact to not only Medicaid recipients, but also to providers who serve large Medicaid populations, such as hospitals, health care centers and nursing homes.

According to Scanlon, “A significant number of low-income residents in Connecticut are expected to lose eligibility for government benefits under the law and will feel the cuts acutely.”

Rural areas in particular are expected to be hard hit, according to state and local healthcare advocates.

Joanne Borduas, CEO of Community Health & Wellness Center with operations in North Canaan, Winsted and Torrington, noted that rural health centers already face significant and unique challenges.

“Add to this Medicaid cuts expected to be a trillion dollars over the next 10 years and these challenges become a crisis,” she noted. “When the patient population you care for is approximately 55 to 60 percent, Medicaid cuts can be devastating to both enrolled patients and providers who the program reimburses for care.”

She further noted that as people become uninsured, “that will make it increasingly difficult for patients to afford their care and for providers like us to be able to offer it.”

The cuts, Borduas explained, “will cause financial hardship, and potential health care staffing shortages at an even greater rate than what we see today, reduced access to care, inappropriate emergency room utilization and uncompensated care stays in our rural hospitals. This could lead to eliminating services and closing doors.”

Natashea Winters, director of programs and learning at the nonprofit Foundation for Community Health (FCH) in Sharon, said an estimated 187,000 state residents could lose their HUSKY health coverage from all federal changes.

“In Sharon, Salisbury, North Canaan, Canaan, Norfolk, Goshen, Kent, Warren and Cornwall, we could see roughly 1,000 people losing their health insurance.”

One in 25 live in a rural area

As of January, 928,986 people, or 22% of the state’s population, were enrolled in Medicaid/Children’s Health Insurance Program (CHIP), representing a 10% increase from pre-pandemic levels in February 2020, according to data from KFF Medicaid Enrollment and Unwinding Tracker.

Of that number, approximately one in 25, or 4% of Medicaid enrollees, live in a rural area.

HUSKY Health includes residents in the Northwestern CT region, where 20.8% of the population is aged 0-17 and 18.5% is aged 65 and older. The Medicaid program serves as a safety net for individuals and families below a certain income threshold who qualify.

That safety net, according to state and local health officials in the rural Northwest Corner, is now threatened.

OBBBA imposes an 80-hour per month work requirement for the first time, increases eligibility checks to twice annually instead of once and imposes new cost-sharing for HUSKY D enrollees.

Also, those with incomes above the federal poverty level will face new co-pays that could deter care, according to the state comptroller’s report.

Connecticut is expected to face $20 million to $50 million in new costs for technology, staffing, assessing and tracking work requirement compliance and exemptions, administering co-pays for certain enrollees and other staffing, the report notes.

Although the legislation does provide some implementing funding for states, the state share of benefit costs could drop by $50 million to $100 million per year due to lower enrollment, according to the state’s assessment.

Changes to work requirements

FCH’s Winters noted that changes to work requirements represent the biggest source of federal savings, followed by restricting provider taxes and repealing enrollment rules.

“To understand what’s coming, it’s worth looking at what happened when Arkansas implemented Medicaid work requirements in 2018. One in four people subject to the rules lost their health coverage within seven months,” she said, noting that “only one in 10 got their coverage back the next year.”

Most people didn’t lose coverage because they weren’t working, Winters noted. “They lost it due to paperwork and reporting problems. A third hadn’t heard about the new rules, and nearly half weren’t sure if they applied to them.”

“Limited internet access for online reporting, seasonal work, multiple part-time jobs without regular paystubs and caregiving responsibilities,” are challenges in our area, noted FCH’s Winters.

“Documenting 80 hours of work monthly can be difficult even for people who are working. When people lose health insurance, they still get sick and have emergencies,” she said.

“They show up at medical facilities without coverage, creating a ripple effect. Individuals delay care until conditions worsen and cost more to treat. Hospitals absorb uncompensated care costs, which get passed to everyone else through higher medical bills and insurance premiums.”

This directly affects our local hospitals, which serve many Medicare patients alongside those losing HUSKY coverage, noted Winters. “While the federal legislation includes a $50 billion rural hospital relief fund over five years, experts say this won’t offset the much larger Medicaid cuts.”

Medicaid beneficiaries may face reduced services or longer travel distances for care. “The new requirement takes effect in December 2026, giving us two years to prepare,” said Winters, noting that “the Arkansas experience shows what we can expect, and what our residents, healthcare providers and local officials should plan for now.”

Impact on Sharon Hospital

Sharon Hospital president Christina McCulloch described the facility as a “mission-driven organization, which takes all-comers, regardless of a person’s ability to pay for the care provided.”

She estimated that slightly more than 10% of patients are covered by Medicaid, according to a 2023 OHS report of the financial status of the hospital, the last audited financial year available.

“While our affiliation with Northwell Health best positions us to navigate the new legislation, these deep funding cuts will significantly affect rural hospitals like Sharon Hospital, which has long faced financial strain due to chronic underpayment by government payers,” said McCulloch.

“Leaders in Connecticut await further clarity on the rollout and implementation, but early indications point toward an anticipated annual impact of approximately $1 billion over the next decade. As always, we remain committed to welcoming all those who need our care, improving patient health, maintaining essential services and keeping our community informed.”

Threat to eldercare

Eldercare is also an area that could be severely impacted by OBBBA, according to health officials, particularly in the Northwestern Connecticut region, where 18.6% of the population is aged 65 and older.

At the Geer Village Senior Community in North Canaan, CEO Shaun Powell noted that it’s “business as usual for now, but I think all of that is going to be unfolding over the upcoming year or two.” He predicted, however, that for a number of people, and the facilities caring for them, “the impacts could be huge.”

In June, more than 700 long-term care advocates descended on Capitol Hill in opposition to the then-proposed H.B. 1 legislation.

According to a survey from the American Health Care Association (AHCA), an overwhelming majority of nursing home providers expressed deep concern about potential Medicaid reductions. More than one-quarter of respondents reported that reductions would force them to close.

The survey, conducted by AHCA in May 2025 of 363 nursing home providers, reflected growing concerns by long term care professionals across the country as congress debated the budget reconciliation package that included federal spending reductions to Medicaid.

Of the respondents, 52 percent identified as independent, single-facility operators and 60 percent are from rural areas.

Clif Porter, president and CEO of AHCA, said at the time that “any reductions to Medicaid would be devastating to seniors, caregivers and communities.”