HARTFORD–The CEO of Connecticut’s online health insurance exchange called a letter sent to hundreds of residents a “bump” after it mislead a Greenwich couple with cancer into thinking their health insurance had expired.
“This letter should not have come out to the customers,” Access Health Connecticut CEO Jim Wadleigh said on Tuesday.
Fox CT obtained a copy of the letter sent to Denise and Akram El-Tayyeb from Greenwich. It states that the couple is ineligible for Husky health insurance, Connecticut’s version of Medicaid, because they do not meet the financial criteria. Because of that, the letter says that their health insurance coverage and coverage for their three teenage sons expired on July 31, 2015.
Akram El-Tayyeb has stage 3 gastrointestinal cancer.
“I was like this, has got to be some kind of mistake. How could they do this?” Denise said.
The letter states that Denise and Akram are no longer eligible for Husky after a new state law lowered the Husky income requirement in the face of a budget crisis. However, state law allows the couple to stay on their plan for another year because Denise earns income from a job.
The El-Tayyebs received the letter just days after another letter from the Department of Social Services was sent to them stating that they still had a year of coverage. Denise claims when she called DSS and Access Health CT, neither agency could confirm that her coverage had not expired.
Wadleigh said the deceiving letters were sent due to a computer system modification.
“This is a new law and some new changes and there’s going to be some bumps a long the way. What you’re seeing is a bump. This isn’t the first bump. Do I think it will be the last of the bumps? No, I don’t,” Wadleigh said.
Denise turned to Access Health CT for health insurance coverage. She said the Access Health CT plans had deductibles averaging $10,000, money she claims the family does not have. In a desperate attempt to pay for her husband’s chemotherapy, Denise claims she asked her employer for a 25-percent pay cut so the family could go back on Husky coverage.
“I did it to save my husband’s life,” she said, “He was not going to be able to have chemo on Tuesday.”
After Fox CT became aware of their story, Denise said she was contacted by a DSS spokesperson, David Dearborn, who told her that her coverage was never interrupted and that the first letter she received superseded the second letter.
“He basically said that he had urged you [Fox CT] not to even mention the fact that I took a pay cut because he didn’t want that getting out to 750,000 people who are on Medicaid. He couldn’t understand what would possess me to do such a thing and that the first letter superseded the second letter. And, I said to him, how was I supposed to know that?” Denise said.
Fox CT reached out to Alta Lash, the executive director of United Connecticut Action for Neighborhoods and an advocate for people on Medicaid. Lash claims that clients of hers have had other troubles with DSS, including long wait times at DSS call centers and letters with misinformation.
“We should be getting better service in Connecticut. All of us. We are taxpayers. We are paying for this. It should be better provided,” Lash said.
David Dearborn from DSS declined to give an on camera interview for this story. He sent an email saying in part:
As to why Denise could not get her question resolved when many other enrolled do contact the DSS/Access Health CT system and get questions answered and issues resolved, we would not be able to tell. We have 750,000 enrollees, and some contact us thru phone or email (including to me directly as my name is on the DSS site and I get emails off the HUSKY Health website) to resolve questions. We handle each one. Some come though legislative offices. We could not advise as to why Denise did not “get thru” and felt she had to lower her income, when many, many others do reach us. Again, the matter of Denise intentionally lowering her family income to qualify for public benefits (especially when she received a notice saying her benefits are good for another year) is one you should consider carefully, we would submit. It was not necessary.
Jim Wadleigh advised Access Health customers with concerns to call the exchange or a broker. He also said that the Affordable Care Act prevents customers from paying more than 9.5 percent of their annual income in healthcare expenses.