Cassidy Friedl noticed her son Luca's eyes drifting and knew something was wrong. But when she called a pediatric ophthalmology office to get him seen, she was told the next opening was nearly nine months away — a delay her family says came down to one thing: Luca is covered by Connecticut's Medicaid program, known as HUSKY.
Luca, who lives with Friedl in West Suffield, was eventually able to get in sooner after a cancellation freed up a slot, cutting the wait to four months instead of nine, according to CT Mirror. He was diagnosed with accommodative esotropia and amblyopia and was prescribed glasses to help correct his eye drift. “Healthcare should not be a luxury,” Friedl said, according to the Hartford Courant, which reported that she felt her son was not getting timely, vision-saving help because of his insurance.
One Doctor, 30 Patients a Day, Barely Room for Medicaid
The bottleneck is not unique to Luca's case. Dr. Cara DeBenedictis, a pediatric ophthalmologist who practices at Refocus Eye Health in Bloomfield and also sees patients in Waterbury, told CT Mirror her office has a 10-month wait for patients with Medicaid coverage, compared to a three- or four-month wait for patients with other insurance. She sees about 30 patients daily but can generally accept only one or two new Medicaid patients a day before the economics stop working, the outlet reported. Her office maintains a cancellation waitlist and says it finds a way to take any patient immediately who has a vision-compromising or life-threatening condition.
Another provider's experience shows how quickly that math can turn against Medicaid patients altogether. When Dr. Janine Collinge opened her Rocky Hill practice in January 2025, she accepted patients regardless of insurance type, per the same CT Mirror account. But rising utility costs and investments in electronic health systems, recruiting and employee retention wiped out most of the money coming in, and she began limiting daily Medicaid appointments before deciding in January 2026 to stop accepting new Medicaid patients altogether. Collinge said the state reimbursement increases passed in 2026 still were not enough to make it financially sustainable, and she has compared the situation to being asked to work without a pay raise for 20 years.
Only Five Of Ten Pediatric Eye Doctors Still Taking New Medicaid Cases
Connecticut has roughly 10 pediatric ophthalmologists, according to providers' estimates cited by CT Mirror, but only five currently accept new patients with Medicaid — DeBenedictis, three Yale New Haven Health physicians, and one Connecticut Children's physician. Christine Stuart, a spokesperson for the Department of Social Services, told the outlet that a Medicaid provider review found about 21 ophthalmology groups enrolled in the program statewide. At Yale Medicine, pediatric ophthalmologist Dr. Martha Howard said the practice does not restrict patients based on insurance provider, but the Hartford Courant reported that all children, regardless of coverage, face waits of nine to 12 months there, with exceptions made for urgent cases. Howard said low Medicaid rates can exacerbate wait times even for privately insured families, since practices that accept Medicaid patients absorb costs across their entire patient pool.
The squeeze on pediatric eye care reflects a nationwide shortage, not one specific to Connecticut. A study found that 90% of counties throughout the United States did not have a pediatric ophthalmologist, according to Managed Healthcare Executive, which also reported that concerns about the economic viability of such practices contribute to the disparity. Chris Collibee, a spokesperson for Governor Ned Lamont's budget office, said pediatric ophthalmologist shortages and long waits are a nationwide problem, not something unique to Connecticut, the Hartford Courant reported.
Rates Frozen for Nearly Two Decades, Then a Modest Bump
In 2026, Connecticut updated its Medicaid reimbursement rates to equal on average roughly 60% of 2025 Medicare rates, per a DSS spokesperson cited by CT Mirror. Before that update, the Hartford Courant reported that Connecticut's Medicaid rates had not been broadly increased since 2008 and equaled about 57.5% of 2007 Medicare rates — while CT Mirror separately described the freeze as dating to 2008 as well, with rates hovering near 57.5% of 2007 Medicare levels before this year's change. A separate state-commissioned study found that outpatient services across a number of practices were reimbursed at significantly lower rates than in other states, as reported by CT Insider.
HUSKY covers about one quarter of Connecticut residents and around half of the state's children, according to the Hartford Courant, and roughly three quarters of the state's Black and Hispanic children had HUSKY coverage in 2024, per DSS data and population estimates cited in that reporting. The Department of Social Services spent $3.8 billion on Medicaid in fiscal year 2026, according to a comptroller report, and the federal government generally matches every dollar Connecticut spends on Medicaid patient care, with states deciding covered services, eligibility and physician payments.
Lawmakers Pushed a Bigger Fix, but It Stalled
State Rep. Jillian Gilchrest, co-chair of the legislature's Human Services Committee, said low Medicaid rates create two main problems: they limit access to care and strain the workforce, according to CT Insider. She told the Hartford Courant that Medicaid reimbursement remains unfixed and that providers simply cannot afford to cover the care. In 2025, the Human Services Committee passed unanimously a proposal to raise all Medicaid rates to 75% of Medicare by 2029, but it never reached a floor vote.
Sen. Matt Lesser, the committee's other co-chair, said Connecticut needs to invest more in physician reimbursement and said he thinks the committee will likely propose meaningful increases again in 2027. Sen. Jason Perillo, the ranking member of the committee, said low Medicaid rates contribute to higher private insurance premiums, echoing concerns hospital executives have raised that low Medicaid payments push hospitals to negotiate higher commercial insurance payments. The current fiscal-year budget includes $50 million more for physician reimbursement than the budget two years earlier, though independent doctors continue to cite insufficient payment as a reason they limit the number of Medicaid patients they serve or decline to see them at all.
What Comes Next for Connecticut's Medicaid Rates
A first phase of a state Medicaid rate study found Connecticut paid less than peer states for specialist physician and behavioral health services, and a second phase concluded the state would need to spend $150 million more annually to meet recommended rate benchmarks. Jeffrey Beckham of the Lamont administration said in 2023 that Connecticut planned to update Medicaid rates the following year, though the governor's 2024 budget proposal included no rate increases as officials said they wanted to wait for the full study before prioritizing which rates to raise.
Collibee said the Lamont administration is preparing budget options for the governor to consider, and that Lamont supports sustainable Medicaid rate increases while wanting large corporations to take greater responsibility for employee health benefits. Advocates and some lawmakers from both parties say the governor's proposed increases have fallen short of what is needed, even as Medicaid has faced large cost overruns and federal cuts continue pressuring social service programs. The governor's next budget proposal is expected in February 2027. DeBenedictis said Medicaid rate increases have repeatedly stalled at the governor's office, according to the Hartford Courant's reporting.
