As we approach Jan. 1, 2014, and full implementation of the Affordable Care Act, we expect that 25,000 to 50,000 people will have new health care coverage through Connecticut's adoption of the Medicaid expansion. That's the good news.

The bad news is that 37,500 low-income parents are at risk of losing access to health care. Gov. Dannel P. Malloy has proposed reducing the income eligibility levels for HUSKY A (Medicaid for children and their parents) for parents from 185 percent of the federal poverty level to 133 percent. For a family of three, income eligibility levels would drop from about $36,000 to about $26,000.

The governor suggests that these parents will find affordable health care on the soon-to-be-established Health Insurance Exchange or AccessHealthCT. Everything we know about the plans to be offered in the exchange and the situations of HUSKY parents says this will not happen.

A recent study by researchers at the University of Massachusetts Medical School Center for Health Law and Economics estimates that between 7,500 and 11,000 affected Connecticut parents may not purchase insurance through the exchange because of premium costs, and that those parents who do purchase insurance may limit the use of needed health care because of high co-pays and deductibles.

Since this proposed change was announced, we have heard from parents who would be affected. These are families on the edge of financial stability.

•The state Department of Social Services estimates that about 32,000 of the affected parents work.

•They are caring for children who are enrolled in HUSKY A; that is a condition of eligibility.

•They are often in school while working. They hope additional education will allow them to get jobs that offer health insurance and to make enough money to be able to pay for that insurance.

•They have incomes below what the state's self-sufficiency standard says a family needs to meet basic needs.

They are juggling responsibilities and finances and are making it — just. They are taking steps toward self-sufficiency. But their situations are fragile.

The premiums for a parent with two children earning $26,000 in the exchange would be $780 a year, even with available federal subsidies. At 185 percent of the federal poverty level ($36,000), premium costs would be about $1,900 for a family of three. In addition, there will be co-pays and deductibles in the plans in the exchange.

The UMass study found that total out-of-pocket health care costs for affected parents would increase by an average of $1,800 per year. Parents with high medical expenses would face much higher costs. In one example in the study, a family with $12,000 in medical costs would have to pay $3,155 out of pocket for needed care.

An affected parent simply said, "HUSKY has been a lifeline that has helped us to get the affordable health care we need. After rent, utilities, food, and other costs, we just don't have room left for new health care premiums and co-pays."

Children would also be affected by these changes in parental coverage. National studies have shown that children who are eligible for public health care programs are less likely to be enrolled in those programs if their parents are uninsured. An understanding of this link between coverage of parents and coverage of their children is one reason that Connecticut's HUSKY program has matched parent's and children's eligibility since 2007.

The proposed change in HUSKY eligibility would leave currently insured parents and children without insurance. This is not the promise of the Affordable Care Act and it does not reflect Connecticut's long-standing commitment to affordable, quality health care for all our residents.

Jane McNichol is executive director of the Legal Assistance Resource Center of Connecticut, based in Hartford.