Governor Corbett’s Healthy PA proposal to reform the Medicaid system in Pennsylvania through a Medicaid 1115 Demonstration Waiver has been met with harsh criticism by many and for good reason. Healthy PA (known fondly by some as Unhealthy PA) would disrupt the current cost-efficient Medicaid program in Pennsylvania by enrolling newly eligible individuals and many currently existing Medicaid beneficiaries into private health insurance plans.
So, why is this a problem? A couple of reasons:
- Historically, private health insurance plans do a poor job of providing coverage for specific types of illnesses. For example, the lack of private coverage for mental health and substance use disorders called for the enactment of federal legislation known as the Mental Health Parity and Addiction Equity Act.
- Private health insurance companies spend much more money on administrative costs and profits than Medicaid. This means that administering the Medicaid program through the private insurance industry will mean less bang for the tax payers’ buck.
Additionally, Governor Corbett’s plan includes many controversial provisions that are likely to face close scrutiny by the federal government:
- A monthly premium for individuals making as little as 50% of the federal poverty level (less than $6,000/year).
- Work search requirements (no other state in the United States has such a provision). As a side note this would apply to certain individuals who meet “medically frail” criteria, but that are otherwise “able bodied.”
- A $10 co-payment for “non-emergent” emergency use.
- Harsh punitive measures that would disqualify households from Medicaid if the fail to pay their monthly premiums.
- Benefit limits that would substantially reduce scope of coverage that is currently offered through Medicaid.
Perhaps, most importantly, the plan is not set to go into effect until January 1, 2015 (assuming it would get approval by the federal government by this time) meaning hundreds of thousands of Pennsylvanians will fall into a “coverage gap” qualifying for neither Medicaid or a tax subsidy through the health insurance marketplace. These individuals will have no source of meaningful health coverage for the entire year. Not to mention, delaying expansion until 2015 will cost the Commonwealth 2.5 billion dollars of potential funding.
Advocates representing many different groups and organizations have voiced their opinion on the plan. Not all of the testimonies provided and comments submitted were adamantly opposed to the plan, but many were. The following is a list of organizations’ comments and/or testimony on the plan:
- Community Legal Services of Philadelphia
- Project HOME
- Public Citizens for Children and Youth
- Disability Rights Network of Pennsylvania
- Hospital and Healthsystem Association of PA (HAP)
- Delaware Valley Healthcare Council of HAP
- Safety Net Association Pennsylvania
- Community Behavioral Health of Philadelphia (CBH)
- Pennsylvania Association of County Drug and Alcohol Administrators
- Pennsylvania Association of County Administrators for Mental Health and Developmental Services
- The Alliance of Community Service Providers (Testimony January 3rd)
- Philadelphia Department of Behavioral Health & Intellectual disABILITY Services (DBHIDS)
- Philadelphia Department of Behavioral Health & Intellectual disABILITY Services (Appendix A- Questions to PA DPW on the plan)
- The Philadelphia Coalition
- Pennsylvania Budget & Policy Center
- Todd Keefer, York County resident
- Center for Advocacy for the Rights and Interests of the Elderly (CARIE)
- Pennsylvania Partnerships for Children (PPC)
- Rehabilitation and Community Providers Association (RCPA)
- The ARC
- Pennsylvania Homecare Association
- Public Interest Law Center of Philadelphia (testimony of staff attorney, Benjamin Geffen, on January 3rd)
- A coalition of organizations representing individuals with disabilities
- Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC)
- Juvenile Law Center (JLC)
- Pennsylvania Association of Medical Assistance Manged Care Organizations
- Women’s Law Project
- Greater Philadelphia Chamber of Commerce
- Joanne Grossi, Health and Human Services (HHS) Region III (House Democratic Policy Committee Meeting: January 8, 2014)
- Joan Alker, Center for Children and Families, Georgetown University (House Democratic Policy Committee)
- Jim Willshier, Pennsylvania Association of Community Health Centers (House Democratic Policy Committee)
- Sol B. Vazquez-Otero, Disability Rights Network of Pennsylvania (House Democratic Policy Committee)
- Jacob Bowling, Mental Health Association of Southeastern PA (House Democratic Policy Committee)