Connecticut Republicans Call for Medicaid Audit Amid Rising Costs

Republican lawmakers in Connecticut’s state Senate are pushing for an audit and further assessments of the state’s Medicaid program, which has been dealing with significant cost overruns recently.

The GOP caucus, holding 11 out of 36 Senate seats, has reached out to state auditors John Geragosian and Craig Miner, urging them to pinpoint possible efficiency measures that could save taxpayers money.

Senate Minority Leader Stephen Harding from Brookfield is also asking the General Assembly’s Human Services Committee and other relevant legislative groups to investigate what factors are contributing to soaring Medicaid expenses once the regular 2026 session kicks off in early February.

“Something’s off, and we need to figure out what it is,” Harding remarked, referencing recent projections from Gov. Ned Lamont’s budget office which estimate that the Department of Social Services may exceed $3.7 billion in Medicaid costs this fiscal year, a figure that began on July 1st.

Last month, Social Services Commissioner Andrea Barton Reeves informed the Connecticut Mirror that the escalating prices of pharmaceuticals and inpatient hospital services are stretching Medicaid budgets thin.

Factors such as increased demand for behavioral health services, staffing shortages, and medical inflation are all contributing to the rise in inpatient care costs.

Chris Collibee, Lamont’s budget spokesman, noted that the administration is monitoring the situation closely; however, economic shifts and other aspects could also influence Medicaid.

Yet, Harding observes that Connecticut is grappling with issues beyond just Medicaid this year.

Congress has allowed an additional $284 million to cover Medicaid cost overruns for 2024-25, with records from the comptroller’s office showing that the program exceeded its budget by $166.3 million in 2023-24.

Harding admitted that part of Medicaid’s expansion could be attributed to an increasing number of Connecticut families struggling to cope with high living costs.

According to the United Way of Connecticut, 581,000 households—around 40%—failed to meet their basic “subsistence” budget in 2023.

Additionally, minority Republicans in both the state House and Senate believe the Democratic majority is also inadvertently broadening Medicaid.

This year, the state began providing coverage for children under 12 from families without establishing their immigration status. Initially, they expected about 4,250 children to enroll, but projections now suggest this figure could climb to 15,000 by July 2024.

Moreover, in 2023, lawmakers mandated Medicaid coverage for services offered by medical coaches and community health workers while relaxing eligibility restrictions for Husky C.

Lawmakers have also taken steps to increase long-standing low Medicaid payments to providers who care for low-income patients, though at rates significantly less than needed. It’s worth noting that these reimbursement rates haven’t been substantially updated since 2007, making it difficult for many insured patients to find doctors.

On the other hand, Rep. Jillian Gilchrest from West Hartford speculated that the majority of Democrats in the General Assembly are unlikely to cut Medicaid funding.

Gilchrest, who is pursuing a congressional seat, mentioned that she’s open to having a human resources committee explore ways to make Medicaid more efficient.

“We definitely need to think about reforming the health care system,” she said, but also emphasized that such changes shouldn’t reduce support for those who need it most.

No responses were received from Geragosian and Miner regarding Senate Republicans’ inquiries late Friday.

Currently, Medicaid undergoes several audits annually; however, these reviews often don’t primarily focus on cost efficiency.

Auditors are required to conduct a federal single audit each year, which looks into billions spent by Connecticut on Medicaid, welfare, housing, transportation projects, and other federally supported programs. Geragosian and Miner’s team also audits state social services operations every two years, while the Department’s Office of Quality Assurance regularly assesses state Medicaid programs.