State Rep. Christine Conley, D-Groton, is reintroducing a bill in the state legislature to make it easier for New London County residents with Medicaid to access medical specialists.
The bill is meant to fill in a gap that exists, said Conley, for individuals who need “a little more care than primary care, but not emergency care.”
She said the bill targeted at, as an example, a person with mild high blood pressure, or a diabetic, or someone needing follow-up care after a surgery more specialized than they can receive at a Community Health Center. And not all private practices or specialties will accept Medicaid.
Conley said that some of her constituents who want to see certain specialists have to go to one of the bigger hospitals in Hartford or New Haven, an hour’s drive from southeast Connecticut. For low-income individuals who can’t afford to take a day off work and who have no available transportation, this creates a difficult situation.
“It is really a have and have-nots issue, with access to health care,” said Conley.
Continuity of care is also an issue, said Conley. It’s not enough just to have a specialist available, she said, but people should be able to continue seeing the same specialist, someone who knows their history and can work with them overtime.
The bill was first proposed in 2020, but was never brought forward after the pandemic halted all legislative debates mid-session last year.
Dr. You Sung Sang, president-elect of the New London County Medical Association, said he believed that New London County was actually pretty well staffed in terms of specialists, with the exception of dermatologists and pain management doctors. He also said that certain surgical subspecialties require that patients be transferred to other hospitals.
Sang said that most of the specialists in New London County do accept Medicaid, which he believes is fairly unusual in Connecticut.
Medicaid offers lower reimbursements than other forms of insurance, including Medicare, said Sang, which makes it difficult for doctors to sustain practices while serving large numbers of patients who use Medicaid. However, he said most doctors understand how important it is to be able to treat those patients, especially if the alternative is having them end up in the emergency room.
Sang said he believed that the continued reimbursement of telehealth was critical for doctors to be able to continue to accept Medicaid patients, especially since no one knows how long the effects of the virus will last.
In the July special session, the state legislature passed a bill that made telehealth available to a greater variety of health professionals, included audio-only and audio-visual platforms in the definition of telehealth and required that insurance companies reimburse telehealth visits at the same rates as an in-person visit. This legislation is set to expire on March 15, and Conley agrees that it needs to be extended.
Conley said that while her proposal discusses the expansion of telehealth, she saw this as a means to get the conversation started, and not an end in itself.
“Telehealth is better than nothing,” said Conley, who said that telehealth can be effective for follow-up appointments and certain mental health services.
However, she doesn’t want expanded telehealth to mean that people no longer have the option of seeing a doctor in person.
Her ultimate goal would be to bring some specialists from some of the bigger hospitals, such as Yale-New Haven, out to Lawrence and Memorial or Backus Hospital, the two major hospitals in southeast Connecticut.
Conley said the biggest obstacle to the bill was funding — she said that she didn’t yet know what it would cost to bring these specialties to the area. She said that she hopes that some support can come from the national level — for instance, if the new administration gives the states more federal dollars for Medicaid. She’d also like to see the federal government do more to encourage specialists across the country to accept Medicaid.
Sang said that anything the state could do to encourage doctors to stay in Connecticut would be helpful. He said that a program that forgives student loans would be one possibility.
“We still know that Connecticut is not a great state to practice medicine,” said Sang.
While Conley agreed that getting more people in to see specialists could save the state government money in the long run, with fewer patients ending up in the emergency room, she added that benefits would come in a more personal form. For a diabetic, it could mean saving a limb, or it could mean a child with a medical condition getting the care he or she needs.
“[It’s] not just the financial savings,” she said. “It’s the savings of people’s health.”