♪ > > This week on the Wheelhouse community and the future of Medicaid in Connecticut in communities across the country.

♪ > > Working at a good public on Frankie Graziano.

This is the Wheelhouse we show that connects politics to the people.

We got your weekly dose of politics in Connecticut and beyond right here.

Elon Musk in the Department of Government efficiency.

Want to cut nearly 1 trillion dollars in federal spending by this September.

So far.

Do XYZ, cancel contracts laying off thousands of federal workers ended leases and more.

Those account for a small slice of the spending pie.

The federal government spends the most money on things like veterans benefits and services, Social Security.

> > Medicare and Medicaid.

> > Many people in Connecticut and across the country rely on Medicare and Medicaid for health insurance.

> > So how could federal funding cuts impact their access to medical care?

Tell me break this down.

I'm joined by Connecticut State Comptroller Sean Scanlon.

Concho.

Thank you so much for joining.

Good morning, Frank.

Good to see you on the Wheelhouse this morning.

We also spoke ahead of this hour with state Representative Vincent Candelora, the House Republican leader, Representative Candelora can join us live due to a scheduling conflict.

But you'll hear some of his thoughts on the future of Medicaid this hour, too.

Let us know if you've got questions for state comptroller.

Sean Scanlon join the to date 7 to 0 967-7888, 720-9677, comptroller residents in Connecticut rely on both Medicare and Medicaid.

> > Before we dig in the latest, I want you to remind us of where they overlap and where they might not, how they're different.

> > Well, the most simplest explanation, Frankie, is that Medicare is health insurance for people over the age of 65 and Medicaid is health insurance for small children.

People with disabilities, seniors in nursing homes.

It's a million people total who are on Medicaid right now.

The state.

> > One of the residents that rely on Medicaid.

It's your friends.

It's your neighbors.

It's your loved ones.

It's the children of our state.

It's people with disabilities.

Its people.

> > Who are in nursing homes, seniors who go to nursing homes, use Medicaid, not Medicare for that.

It's low income people at its most basic level.

It's the most vulnerable people of our state and about it.

3rd of our state in some ways benefiting from Medicaid.

And it's a million people that are in every single community and our state.

> > Are there concerns about both Medicare and Medicaid at this moment or one of those bear the brunt of the cuts?

Well, as the chief financial officer and fiscal watchdog of the state, I'm worried about everything.

But I think the most pressing thing right now is Medicaid because Congress has passed a budget reconciliation act.

> > That has instructed the committee that is in charge of Medicaid and Medicare to find 880 billion dollars of cuts over the next 10 years.

And the non-partisan Congressional Budget Office said that if they cut every single thing in their committees jurisdiction.

Frankie, besides Medicaid and Medicare, they still need to come up with 600 billion dollars of cuts.

So I think and the state thinks that we are on course to see them try to cut Medicaid and we are doing our best to prepare for that and model out different assumptions that but I have to tell you that everywhere I go, whether its conversations with hospital leaders, whether it's conversations in the grocery store, people are freaked out about this and they should be because this is a lifeline program for many, many, many people in our state.

> > When it comes to potential cuts to Medicaid.

Tell us more about the impact that would have on Connecticut's residents.

Well, like I said, this committee has not released the details of how they're going to do it.

But it's a math equation the math guy.

So I can tell you that.

> > There's no way for them to get to the cuts that they need by the way, they're doing this to fund an extension of the president's tax cut for the wealthiest in our state and of the wealthiest in our country.

And they're doing that almost certainly by cutting health care for the most vulnerable population, Connecticut.

So the governor and to the commissioner of the agency that oversees Medicaid have been doing a bit of modeling.

Our office has been involved in that, but no matter what they decide to do any cut.

I want to be very clear what have devastating consequences for the people in the state and sometimes as we discuss this and we talk about the get 6 billion dollars of federal aid for Medicaid, theirs, 880 billion dollars of cuts and there's a million people.

We sort of get lost in the clouds of numbers.

This is about your child who may be on that.

Okay.

This is about your disabled sibling who is receiving health care because of Medicaid.

It's about your grandma or your grandpa.

In a nursing home, everybody in this state's life will be touched in some way by this.

It's not abstract.

It's real.

> > This is.

> > Both a federal and state program.

What responsibility does?

I think you just kind nailed it right there at the end.

> > What responsibility does Connecticut to this program to make it up?

Both the state and federal bench or so how Medicaid works is that the state puts forward some money and the federal government matches that and they do most cases beyond matching.

And so, for example, it's a 3.3 > > Billion dollar program in our state.

But we get 6 billion dollars in the last fiscal year from the feds for that.

So altogether, over 9 billion dollars is spent on.

This is one of the biggest things that we do has the state.

But we are heavily reliant on that federal share to come in as is every other state in the country.

And so we have some flexibility of how we can design our program here and who recovered who we don't.

But all of us rely on that.

What's called federal share of Medicaid.

Any cut to that federal share will result in cost cutting benefits here in the state because, well, we have turned around our fiscal house that we have a very healthy, rainy day fund to 4 billion dollars.

We just simply can't compensate for all the federal money that we would use both for Medicaid and for every other program that we're seeing cut almost on a daily basis here in the state of Connecticut because of what's happening under President Trump and Elon Musk.

> > In your 2025 comptroller's Healthcare cabin.

A report.

You said that increasing reimbursement rates for Medicaid and Medicare.

A top priority.

Why is this issue so pressing?

Well, look, it's somewhat of a like a dual world that we're living here, right where we came into this year of 2025.

As the state.

> > Trying to raise the Medicaid rates, which is something that we have tried to do in the state for a long time.

We are under funding in my mind.

A lot of the Medicaid rate providers that are helping the people that are on Medicaid.

And when you don't properly fund them and when you don't raise their reimbursement rates less and less doctors see Medicaid patients and that is very bad for the people who are trying to get seen by a doctor.

Obviously.

So we came into this year, both the governor, myself, my cabinet, the legislature all wanting to increase the Medicaid rates and we still do.

But it will be almost impossible for us to raise the rates when we're talking about just trying to hang on.

If we see less federal money.

So, you know, this uncertainty right now we're doing our best to navigate how to balance the state budget this year and put more money into Medicaid at the state level while also recognizing that in the next few months were few weeks, we may see a very, very different reimbursement for the federal government.

And that is what's causing a lot of people to sleep at night just to underscore that point at the end there, you're talking about potentially losing 6 billion dollars.

> > In matching funds and be on from the federal government.

You pointed out that there's 4 billion dollars in the rainy day fund.

So it's not as easy as just reaching out to be on the fiscal guardrails to try to help you with Medicaid.

That's just one part.

Then you have obviously other find funding priorities that people have nonprofits or even something like funding higher Ed.

So this just kind of illustrates the task that you guys have ahead of and how hard it may be, too.

I guess do it all in one shot here in the session.

> > But look, I want to be clear, I don't think that even President Trump with Republicans in Congress are contemplating not giving us any of that 6 billion dollars.

But losing a billion losing 500 Million.

All of that.

To your point, Frankie will be devastating and blow a huge bolt hole in our budget at a time when we're trying to meet the needs of many people.

We've gotten out of a fiscal crisis and the one that we were in starting in 2017 in my mind has largely ended.

But we now out of Fort ability crisis in our state.

And we're trying to meet that moment.

Well, continuing our fiscal progress using money from Washington that we have counted on for decades in both Democrat and Republican administrations would have serious impacts to are building a worst-case a moment.

A worst-case scenario would be losing everything.

You don't think that's going to happen.

But a bad scenario would be losing.

> > A billion dollars or something like that are 500 Million.

And you think that you would have to make up for that.

Maybe from the rainy day fund or just having to find some money elsewhere.

You think that you have to reach into state coffers to make up whatever you lose.

> > Look, I don't make that decision to the governor and the legislature do, but they both said on record, we're going to do everything we can to protect our most normal people.

But there are limits to what our abilities to do that based on the confines of our budget and the need to help all the people who are also being cut.

But I think that we would do everything we can to step in and we are planning for that moment to actively.

> > As I mentioned earlier, we spoke with a Republican state Representative Vincent Candelora head of this hour.

He told us that any talk about proposed federal cuts to Medicaid from lawmakers would constitute what he says is a quote, deflection of the issue.

Let's hear his comments.

> > So this year's budget, we are over 300 million dollars over budget and Medicaid.

The growth in the projected budget for next 2 years is going to be over 250 million dollars actions over 300 Million.

So they want they don't want to talk about that issue.

And then by June, we have balance constitutional budget and we see got down the road 8 months from now that there's a cut that comes into play that we cannot account for.

Certainly we would have to look at those emergency measures to fill that hole.

But the state should do its own housekeeping right now.

And not wait for what's going to happen down the road.

> > Comptroller, could you respond to what you heard from the state representative there?

It can be both true that there is a shortfall in Medicaid that we have to plug and we are going to plug in this budget.

> > And that a federal court to Washington, which would probably be 2, 3, 4, 5 times more than that shortfall is devastating.

Both of the things are true, but it's not a deflection to say that President Trump and Congress cutting a 6 billion dollar program to us is the elephant in the room several 100 million dollar shortfall.

Well, nothing to sneeze at in the context of a 20 billion dollar annual budget is not the biggest fear that we have do.

We have to plug that deficit?

Absolutely.

Is that health plan experiencing the same challenges that every plan in the world is experiencing higher costs for hospital admission, drugs.

You bet.

But the higher cost of hospitalization drugs will pale in comparison to the problem of us getting billions of dollars, less funding from Washington to care for the most vulnerable amongst our society.

> > I wanted to get a little bit more with rep Candelora to see what he would do to try to solve some of the things he says that need to be done in the interim.

He told us his position on the Medicaid budget is based on what he considers and over usage of of an entitlement program.

He points to a state law that allows children aged 15 and under regardless of their immigration status to be eligible for health coverage through the state ski programs.

Let's hear more from him on that we're > > The growth beyond what was seeing.

budgeted because basically anybody outside of can can come here to receive those benefits so I think we've got a look at the policy overall.

We don't have unlimited resources.

And so we need to prioritize them.

Services are going to be provided which they have to be give a lower level of care that's going to cost the state of Connecticut less money.

Any response to that?

> > I'm not in favor as a father of giving a lower level of care to any child in the state.

Regardless of who they are, where they came from.

These are kids we're talking about here.

It's true that more people have signed up for that program that had been intended.

But it's also true that those kids, as the representative says, if they get sick as all kids do, trust me.

I know that as a father of young kids, they go to the hospital because it's the only place for them to get care and that hospital gets nothing back in return for that.

Our hospitals are stretched to the max.

If you go to an emergency room, any part of the state, it's filled with people and part of the reason for that is because the hospitals are not getting reimbursed properly for the care that they're giving at least in this iteration of it.

We are giving them funds to care for those people.

And when they don't get those funds, they just pass the costs along for that care to all of us, which is a reason why our insurance premiums are through the roof.

So for me, it is a moral issue of covering all children in our state for health insurance.

Do we need to find ways to save money and Medicaid?

Yes.

Are there officials seize?

We can find yes, but we should not be talking about cutting that program.

At the same time, we are expecting massive cuts to take from Washington.

We need to figure out a sustainable game plan to care for the most vulnerable and in my mind, that includes kids.

Any final thoughts for the listeners here?

> > Comptroller scandal.

It's good to have you on the show.

Want to see if you have anything else for us here in this moment.

Everywhere I go in the state people feel a little bit hopeless.

They feel scared.

They feel frustrated and my message to them is.

> > And use your voice.

This is the time for you to call your representative, even if you think that agree with you to put something on social media to talk about how this would impact you and your family and your community when we speak up and speak out and you can still change things.

And even if it feels like the odds are stacked against you right now, change is possible.

And I believe we can stop these cuts, but we have to use our voice.

And if we can't, we have to make a plan.

We're going to do both.

And I'm going to both as the chief fiscal officer of our > > Even listening to state state.

comptroller Sean Scanlon Council, thank you so much for coming on the Wheelhouse.

Thanks, Frank.

We also heard from House Republican leader Vin Candelora.

Thank you so much for him coming on the show as well and giving his thoughts.

I'm Medicaid.

Coming up a deeper look at Medicaid and how federal funding cuts may impact access to care in Connecticut.

Are you someone who will be impacted by cuts to Medicaid?

Give us a call.

888-720-9677, 8, 8, 7, 2, 0, 9, 6, 7, 7, We'll talk to you after the break.

♪ ♪ ♪ ♪ ♪ ♪ This is the Wheelhouse from Connecticut Public Radio.

I'm Frankie Graziano State lawmakers anticipating more cuts to federal funding coming up, Medicaid has one line item that may take some big hits.

Joining me now, Keith Fan of state Richard Roth, finances, reporter for the Connecticut near.

It's great to have you on with us.

Good to be here.

Good to see you this morning.

And also joining us in CO Katie Koala health reporter for the Connecticut mayor.

Thank you so much for coming on.

Katie.

Thanks, Frank.

You've got to hear both that conversation that I had with state Comptroller Scanlon and of course, the talk I had with the House Republican leader Vincent Candelora.

Our phone lines are going to be open now and we'd love to hear folks thoughts about those conversations, Medicaid benefits and the budget.

Join the conversation.

It ate 720-967-7887, to 0, 9, 6, 7, 7, Keith, as I just mentioned, we heard from the comptroller we heard from the Republican leader any reactions to what they had to say about federal and local cuts to Medicaid.

> > To just a little perspective and I know Sean tried to clarify this.

We're not going to lose 6 billion dollars.

I don't think anybody can promise what we're going to lose in a particular year.

I don't think.

Anybody is expecting.

The losses to be in a particular in the billions more likely in the hundreds of millions of dollars.

The other thing is.

When when when Shawn said provider rate increases are impossible.

I don't know if his fellow Democrats in the legislature completely agree with that.

You can't really discuss Medicaid without discussing the guardrail.

So just point out quickly, we haven't updated our medical provider rate since 2007, which means if you're in Husky and God forbid you need to see a specialist.

Doctor, good luck.

Finding one is taking new patients because we have an increased what we pay them.

Since.

Well, it took effect.

Those rates took effect in 2008 since 2008.

The other thing is we are better suited.

That any other state.

To deal with the Medicaid cut because we have been over saving.

Believe it or not, for our pension debt.

We've been running surpluses for the last 8 years of an average of billion, 8.

1.8 billion.

We've been taking 8 to 9% of our budget out every year.

One half of one generation has been trying to solve the pension debt created problem created by 3 and a half.

If people are going to be told provider rate increases are impossible.

Connecticut cannot leach a billion 8 every year out of health care, social services, education County.

Just by the way, so that her pension debt problem instead of being resolved in the early 2050's can now be resolved by the mid 2040's.

That's it.

And other words, we're not saying, well, we're solving this pension problem in the year 2.

So put up with the pain.

It's saying can you hold your breath for 20 more years?

And then will be done that the pace that we're paying up, the tension that has to slow down that will be used to cover the Medicaid gap.

If I can follow that.

And I know a thing that know that's incredible perspective.

Does that extend all the way into into Medicare to > > And essentially I think you're saying it's unsustainable that these hospitals and these providers are paying and not getting the reimbursement is that I think that's what you're saying.

That's a sustainable.

This well meant.

Medicare's purely federal.

So that's lake nearly between the hospitals in the federal government.

But when it comes to when it comes to, you know, Hans Johnson, our hospitals are being stretched.

> > The reason they're being stretched is because we don't have enough doctors who are willing to take on more Medicaid patients.

We have tons of people on husky who are effectively uninsured because they can find to want to treat them or they can get into it.

If we didn't have the federally qualified health centers.

And I'm sure Katie can tell you more.

We would be completely stuck.

We're talking about Medicaid reimbursements here in the situation that people are feeling and it sounds like there's people that are supposed to getting Medicaid.

> > That aren't getting Medicaid.

There are people who are supposed to getting care who are getting care.

So they have Medicaid.

They are technically covered.

> > But when they get sick or need a specialist, for example, and they're going out there and they're looking for a physician who will accept their Medicaid insurance.

They're not finding them.

They might have to wait, you know, at I have private insurance.

I had to wait 8 months for primary care appointment those weights might be the longer for someone with Medicaid.

And that is that because people are concerned that they're not going to get paid back once they see somebody that has Medicaid.

> > So Medicaid, Medicaid reimbursement rates.

We keep saying this, but it probably just where it that is how much the state is paying the doctor.

2, see a Medicaid patient.

It is often much less than what private insurers pay.

So, for example, a doctor see someone with private insurance who has the flu.

making these numbers up, get paid 100 bucks.

But they see someone who > > has Medicaid was the flu and they get paid.

50 bucks and a lot of providers are saying it actually cost more than 50 books, even provide the care.

So we're losing money.

So many providers have to make what they say is a difficult decision to cut down or completely stop seeing Medicaid patients for that reason.

> > I'm going top pick of discussion in the state Legislature.

Can you help me break down exactly what Medicaid embarrassment.

reimbursement rates are.

I know you were talking about that way in the situation around it.

Yes.

So the Medicaid reimbursement rates are just how much the state, any state in this case, Connecticut pays doctors.

> > For services they provide to patients with Medicaid and keys.

And the comptroller spoke to this.

But for years now, providers and legislators have been saying these rates need to come up.

They haven't been raised since 2008.

It's causing access issue for patients and right now other couple.

in the Legislature.

One is from the governor himself.

So in his budget proposal, he is saying let's let's put 35 million dollars over the next 2 years towards increasing rates for certain providers that we know we underpay.

> > The it many providers and he's Democratic leadership say that's not nearly enough.

So Democrat leadership also has proposal that would put 200 to 250 million dollars, I believe are the numbers they've put towards it over the next 3 years to increase those rates that obviously the much, much spent.

> > And at 8, 7, 2, 0, 9, 6, 7, 7, 8, 8, 8, 7, 2, 0, 9, 6, 7, 7, The number to call.

If you have any questions related to Medicaid.

Connecticut's community health centers also called these federal qualified health centers that fq agencies are taking steps toward legal action against the state over low reimbursement rates so far filing a petition, as I understand it.

> > Yeah, that's right.

So they basically filed what's called a declaratory really request.

they sent it to the same.

And they said, hey, these are the federal and state laws around how often you're supposed to review our rates.

And when you're supposed to raise them, do you think you're complying with those laws?

And so now the state gets 90 days to respond.

So I'm wondering if it's we talked about the equation, Keith, with.

> > the comptroller earlier where he saying that we're putting in 3 billion, 3.3 billion, something like that there was more than a match this year from the federal government in his numbers.

He said there was 6 Billion.

Are we saying that the state may have to put even more in to Medicaid to help make sure that some of these folks that are providing care reimbursed.

Well, the putting in more just give people an idea at Sean's correct were actually.

> > The 3.3 billion is just what's in the Department of social Services line item.

Connecticut spending on Medicaid about 4.4 billion.

Well, and we get about 6.1 from Washington seeing about 10.5 billion total.

So if the amount from Washington goes down, ours can go up and it still doesn't mean overall.

might be lucky if we're just treading water just just 2 points, though, breaking to build on on what Katie said.

There's this myth in Connecticut.

I really think there is that because we're one of the wealthiest states in the nation, every service that we have is the Cadillac of services.

So even if it's cut back, how bad can it be?

A couple years ago, a Kaiser Family Foundation.

So right now they're kff they ranked we are states are in terms of the Medicaid rates.

They provide the Medicaid rates that we pay.

Specialists.

Ranked 42nd out of 50 states.

When I competing with New York and Maryland, we're competing with West Virginia and Mississippi.

Even though Connecticut is along with New York, one of the 2 greatest states in the nation for income and wealth inequality, meaning there are some folks in Connecticut to have no idea what we're talking about.

And there are other folks who I think I said I had that, you know, basically the same access to specialist doctors.

That's somebody in one of the poor state of the nation would have Connecticut or any state when you ignore a problem.

For 20 years.

You're going to find your grossly out of whack.

And then the other point I just wanted to add is Shawn had mentioned how our nursing homes.

Part of the majority of our residents in nursing homes are on Medicaid.

he's technically correct when he says, you know, we're talking with Medicaid about some of our ports people.

What a lot of the focus in nursing homes.

People from the middle income households.

Had to spend down their assets to qualify for Medicaid.

In other words, they could have gone into a private pay home for a year or 2, but that would have exhausted what they had.

When you say what families have relatives in nursing homes.

They come from basically all.

But but the wealthiest families and we have not been providing inflationary increases to our nursing homes.

For years.

So we've already seen what happens with Medicaid rate when you don't keep up.

Nursing homes aren't quite there, but they're catching up fast.

Katie mentioned earlier the Connecticut's community Health Centers have filed a petition.

> > Or the declaratory.

So miles from the West.

Yeah.

Yeah.

With the state over Medicaid rates.

Word is that petition go from here with the timeline, right?

So the state now has 90 days to respond.

They have the most.

They've said it's just they acknowledge that they've received it in there.

> > You know, they're gonna respond to it in compliance with the law.

But basically, if the if the community health centers don't agree with their responses to those questions, they can then go ahead and file a lawsuit in Superior Court.

> > He does the governor planning to address this issue of rate reimbursement 2025 legislative session, Henri lawmakers even.

Or has even acknowledge this issue.

The legislature task, the Lamont administration couple years ago with doing a study on Medicaid rates and the Department of Social Services has been doing that work.

> > The governor didn't propose any changes.

Does this give you an idea of also weigh in with their cards?

last?

12 months ago?

Basically when they were negotiating the budget for the fiscal year that we're in now.

They had approached the Q A the federally qualified health centers about basically signing away their rights.

To go to arbitration over Medicaid rates.

The Q a cheese didn't bite on that.

I don't think there's a lot of expectations that the Lamont Administration is going to be pushing to bolster Medicaid rates given what's going on right now.

Like I said, it's going to come down to a fight over.

Can we continue to save so incredibly aggressively?

When we've been leaching arguably needed resources away from other problems and then they're about to lose a ton from Washington.

I think we're digging into the nuance here is as you do better than probably anybody into the state.

Keith.

So I appreciate this.

Let's go even further into it.

> > And help me understand I may be out of left field here.

So tell me if I'm out of pocket, but I know that the administration has been talking so much about having to fill in potentially where ever the federal government steps away on Medicaid.

> > But is this it?

I'm listening to what you just also told me.

So it are they may be paying a bit of lip service to that.

Are they actually going to try to do the best they can to to get more money into Medicaid or am I missing part of this issue here?

> > No, I think you're going to see First of all, I do think that if Washington and I expect they will cut Medicaid, the question simply how much do I think the administration will look to patch that.

Sure.

And I do.

I think the governor will won't go as far as say, the majority of the Democratic legislators who control the House and Senate here in Connecticut.

Want to go?

No, I don't think he'll go as far as as they want to go.

The reason I keep going back to these these guardrails, if I had to ask your listeners to come up with an analogy for their household, let's say everybody started bolstering their savings, but you did by dramatically cutting your grocery budget.

You hand your car bill, your mortgage.

All of a sudden that savings and your listeners have to imagine where using sarcastic care quotes around savings.

Yeah, you're going to realize that that savings with not really achieved that healthy fashion.

And now if all of a sudden you've got a pay cut for work as well.

That's how I'm trying to describe the Medicaid situation and he's labored analogy.

You've no choice but to rely on how you save money.

That's what's happening here in Connecticut.

I mean, there have been arguments that.

I mean, when Phiri were only supposed to be saving volatile money, outlier, money meeting of revenues that surge one year that are not likely to do it year after year after year.

Well, the problem is we keep coming up with about a billion 8 surpluses like we're stamping out license plates.

You can have on reliable.

Reliable money it's one or the other.

And are, quote, unquote, volatile money comes in an incredibly stable fashion.

He's talking about volatile money here.

Covid relief dollars obviously playing a a role here.

Covid relief basically still the state during the pandemic for a long time.

And now that money is going away.

We've seen it impact a lot of different places.

Katie, what are you seeing that as far as the impact here and on Medicaid?

> > We know there are some programs that the > > that the state has passed that was and this doesn't just really to Medicaid.

But of course, in general, there are some.

> > Some programs that the state passed that that relied exclusively on arpa funding.

So of course, You know, that that's a game changer.

Now, those funds are not available.

Keith might be able to speak a little more towards whether there's their places in Medicaid that relied specifically on arpa funding.

Go ahead, Keith.

> > Katie's right.

We use money from the American Rescue Plan.

Act to patch up some of the services that we deliver to people with disabilities.

Behavioral health programs for children that we provide.

Most of those services from contracts with community-based private nonprofit groups.

They're usually running on shoestring budgets to begin with.

I always ask people to think of this arpa has sort of the best fiscal novocaine we were while these guardrails were extracting about 9% of our budget every year people would say to me, well, it could have been that bad.

I didn't notice everything going to h*** in a hand basket.

Well, that's because of the same time we were doing that.

I will say we had the good fortune to have a pandemic because that was tragic.

Connecticut received 2.8 billion dollars that basically we could spend between 2021 and this year.

So every year that we extract a big surplus, we put some of it back with this arpa money, which was very flexible.

Emergency federal money could be spent outside the spending cap is the limit.

All that arpa is gone.

Now.

So the canes over and now you're going to really feel that this extraction of money by the guardrails at the same time.

Washington is about to take a big chunk heads-up.

Something has to give and it can't just be cutting programs.

That have largely been neglected for the better part of 20 years.

> > Have a caller right now from North Haven.

Go ahead, Jared.

> > Hello, thanks for taking the call and I appreciate the topic today.

> > Thanks and thank you for coming on.

The show appreciation.

> > Yeah, I have a mother been caring for her with dementia we did what is very common.

We put her in a and did the drain down.

Know she's been in facility for the past 2 or 3 years on medicate and just curious to know what Mike we expect as a family and and also the facility with things on the horizon for Medicaid in the next year or 2.

> > Jared, thank you so much.

Please continue to listen as well.

We'll go into that.

Keith.

That's exactly kind of what you spelled out, what air it's going through now, which we expect.

> > Go L a.

> > Katie, I think my my wife, Jenna car less or my colleague Dave Alta, Marie have done a lot of reporting on the quality of care and nursing homes.

I would urge people to look at the Connecticut Mares elder Care series abs.

> > The industry is.

> > Absolutely struggling.

A lot of people are finding that care is slipping in a lot of our homes that rely on Medicaid funds.

> > That is important to highlight that series gave Alta.

Marie, of course, Jenna doesn't outstanding job reporting on this.

And Katie as well.

Go to senior Dot org.

For more on that.

Katie, can you speak a little bit more to the situation that Jarrett finding himself and his family as well?

Yeah, I mean, I think what Jared is calling in with is just > > really highlighting what the comptroller said earlier, which is that?

These are not just abstract cuts.

They're going to impact everyone so that we don't know exactly what shape these cuts will take or what exactly their impact will be.

But it's very likely that some providers will have to cut services.

We've already seen a community health center that stopped offering dental services because the Medicaid reimbursement rates are too low.

And so imagine that if providers are getting less from the federal government or from the state through the federal government.

They are just going to have to make some cuts to services.

So I expect that access and Walla will the Clyde.

But of course, that will be dependent facility to facility.

I don't want to keep harping on this, but it's tremendous example.

So I think Jared for calling, but help me understand guys where Jared should be looking here or at least you guys are you I don't want you to to to tell Jared a were to do the work for Jared here or to to advocate.

But is he looking at the federal cuts?

Is he looking at reimbursement rates?

Where should he be looking to get more information and what's happening?

I think what direction I guess.

Yeah, I think that probably the impact from the Medicaid reimbursement rates is already being felt.

I would say that what we are looking to towards are those federal cuts.

And I would be happy to do that work for Jared.

If I felt like there was the opportunity to.

But I think right now, you know what?

Legislators providers and everyone is saying it's just we don't.

We don't quite know how this is going to play out just yet.

But as Keith said, it.

Cuts are likely.

It's really a matter of how large they will be.

Yeah.

The the smart analogy answered your question.

Frankie is just, you know, should be looking at this or that or this.

And the answer is yes to all of the above.

> > The problem is Connecticut sort of holding its breath right now along with the rest of the nation.

We typically adopt our budget at the end of the legislative session.

So we be talking about early June, even if they adopt a budget, which they may.

Well, it's almost going to be like a well.

Consider this a first draft.

I think it will be back in special session late summer or even early fall are gasp earlier winter, depending on how affective Congresses in giving us clear direction.

So I think nobody really knows.

How can I say this politely for wn PR when the fit is going to hit the Shan.

But I think that everyone is not sure right now.

So it is we are stuck in sort of a holding pattern.

I hope that passed muster.

> > It did.

I had my arms up a touchdown.

It was a touchdown.

I appreciate it.

We got to dig more into this and whether or not the fit is going to hit the Shan right after this.

You are listening to the Wheelhouse on Connecticut Public.

Let's take a quick break.

♪ ♪ ♪ ♪ ♪ ♪ This is the Wheelhouse from Connecticut Public Radio.

I'm Frankie Graziano, Medicaid.

One of the nation's largest health insurer is the nation's largest health insurer.

I can speak today covering approximately 80 million Americans.

That's according to the Centers for Medicare and Medicaid Services right now, Republican lawmakers in Congress are eyeing government spending cuts.

This could threaten coverage for Medicaid recipients.

So how might that impact Connecticut residents?

Well, we're going to find that out as I made a joke at the break of the arpa dollars of Connecticut Public is the CT Mirror.

They always stand us up here in the Wheelhouse.

Still with me, Katie, go Valla and Keith Fan.

If with a dazzling metaphor is on zoom and of course, Kate ago valleys right here in studio.

You could join us on the phone.

8, 8, 7, 2, 0, 9, 6, 7, 7, 8, 8, 8, 7, 2, 0, 9, 6, 7, 7, Congresswoman Rosa DeLauro.

Katie worries that the federal government will soon jeopardize health care for older adults, children and low-income families.

She joined a group of lawmakers advocating against Medicaid cut last week outside of the state Capitol.

> > These are our neighbors, our friends.

Yeah.

Like that.

We know they are now endangered.

My friends.

Medicaid is in mortal danger.

> > Mortal danger.

Very strong words there.

Have we heard it explicitly stated by the Trump administration that they're eyeing cuts to Medicaid and if not, then why are politicians?

Why are people like Sean Scanlon saying that is going to take a hit?

No, they have not explicitly said that they're cutting Medicaid.

In fact.

> > The Trump administration has said they will not touch Medicaid but need to go back to what the comptroller walked us through as to the cuts that they're trying to the House Republican budget bill calls for 880 billion dollars in savings from the House, Commerce and Energy Committee that committee overseas certain plans the biggest by far are Medicare and Medicaid touching Medicare is like a.

Political 3rd rail like you just don't do it.

And many people believe that even the Trump administration will not touch that.

So now the only option to hit that level of savings that they're looking for.

The only program, big enough that can help them get there is.

Medicaid.

And so that is why despite Republicans and the Trump administration saying they're not gonna touch Medicaid.

That's not explicitly state in the bill.

That is why we're seeing some of the state legislators ring the alarm.

Can you help me understand?

Very briefly, why that's a 3rd rail touching Medicare.

> > doesn't have to do with the fact that most of the people on Medicare might be of a certain.

> > The age or race may have really go out and they okay.

And it just has come to be one of, you know, the most popular federal programs that we had of Keith has anything to add to that.

But no, I I think that's, you know, time is right there that we're sale touch I well, I'm looking for another metaphor.

You want to change my title.

The following mild hooligan, but > > let's tax Jenna.

Let's see what he has to show you.

Exactly.

I think it just comes down to when you mess with retirement benefits, you're asking for trouble at the polls.

So yeah.

And into the Katie's earlier point, if she's right, it simply the math.

You know, you don't have to name Medicaid if I just say that I hate every number between 10 and one.

You know, I'm talking about 2 through 9.

It's just another way of saying the same thing but it and yeah, I think Medicaid is the only way.

2.

Even approach the types of targets.

The Trump administration is talking about.

We have another caller.

It's doctor Daniel Sunderland from West Hartford.

Go ahead.

> > I thank you so much for talking about this important topic.

I'm a primary care doctor.

We're kind of West Hartford and I do take Medicaid at my office.

And I just want to let people know one just reiterating what you something one of your guests said before we all do bear the costs of Medicaid effectively and the reason why is that if your hospital stay, you know, you're going to build their.

That hospital is going to need to cover all the people on Medicaid as well or people who don't who aren't able to pay anything at all, who maybe don't have Medicaid.

So when that gets shifted over to your private insurance premiums.

This is not just to people who have Medicaid problem.

This is a this makes it health care more expensive for all of us.

When those people on Medicaid don't have primary care, they're not able to come in.

They're not able to find someone who takes Medicaid, which I mean a lot of times I feel like I'm in the minority taking Medicaid, but a lot of, you know, some of my colleagues also take Medicaid, but what I try referred to specialist sometimes or people calling around just to find a primary care.

A lot of times the answer they get is I'm sorry, like our our business model has you know, show that we're not able to provide that care.

Danny, I appreciate the contacts.

> > I wouldn't kept talking about this family of 4 minutes left on the show.

I appreciate it.

Thank you so much, Daniel, for calling in.

Please be sure to call into another Wheelhouse shortly.

You heard that perspective of what it's like to be a provider, Katie, and then decide whether or not we're going to take Medicare or Medicaid.

Sorry.

What did you think about that perspective?

> > This is exactly what we've been hearing, what legislators have been hearing from providers all across the state Utley and this becomes an access issue for.

People on Medicaid and it is also, you know, the system is bearing the brunt for these costs in other ways.

> > And then you had Andrea Barton Reeves, Governor Ned Lamont, Social Security services commissioner, talking about work requirements.

I think some people like when you say work requirements.

> > Mainly maybe Republican lawmakers or something like that might generally like that am I referring to this in the wrong context or or what do you think about potentially what we heard there as being a realistic first lap step and then what would happen to those folks who aren't working or can't work?

That's a good question.

> > commissioner said is true what the that there there seems to be a misconception that people on Medicaid don't work > > and I think there was a 2023 studied an and found that 90% working age people who were not getting disability payments were working.

So most of the people who can work are working.

And many other people are in school.

Their caregivers.

So this idea this misconception that she was trying to talk it.

It just the numbers, don't bear it out.

And then you are asking about what what shape these work requirements could possibly take.

And again, I don't think we know, but but under the previous Trump administration, a few states tried to put work requirements in to place.

> > Many of them had the a requirement for how many hours in a month you had to be working.

> > And and many but but not all contained exemptions for > > Who could not work?

So I people.

think.

You know, if I had to guess it would be some kind of our our our base requirement and that there would be exemptions for people who could not work.

Keith, less than 45 seconds to answer the following question.

Cuts to Medicaid impact people across both political parties.

> > I expect that you would imagine that to be the case, might the president keep his promise to, quote, love and cherish Medicaid has political reported back in February or is that lip service what he thinks?

Well, you just you can't have it both ways.

If he does want to cut the federal budget.

Significantly more probably, you know, want to talk about eliminating the deficit, just cutting the budget.

There's just no other way to get around it other than Medicaid.

I would be very surprised if medicated skates and skate.

> > That's Keith fan.

If of the Connecticut mirror, you could see more of his work.

And Katie Go Vols work.

The health reporter at the Connecticut Mirror at CT Mirror Dot or Katie.

Keith, thank you so much for coming on the show.

Thank you for Cape.

Thank you.

Today show produced by Chloe when it was an excellent program edited by Robyn Doyon-Aitken.

And Matt Dalton, our technical producer is dealing race.

Thank you so much to our visuals and operations department here at Connecticut Public and of course, Meagan Fitzgerald and our talk show unit download the Real House anytime on your favorite podcast app.

I'm Frankie Graziano.

This is the Wheelhouse.

Thank you for listening.

♪ ♪