Affordable Care Act, Health Disparities, Health Equity, Health Justice, Health Policy, Health Reform, Inequality, Medicaid, Pennsylvania

PA HB 2138 Heads to the Senate

Pennsylvania House Bill 2138 which would allow for work requirements in Medicaid has successfully been voted out of the Health Committee and will come to a full vote by the Senate. It is critical that PA residents contact their state senator now to urge him or her to vote NO on HB 2138.

This bill will unnecessarily punish families and children living in poverty at the administrative expense of taxpayers. Check out our past blog to remind yourself of how the law would work.

The Urban Institute did a comprehensive review of the literature on work requirements in public assistance programs and found that the evidence shows these programs fail to meet their stated goals at the detriment of individuals losing life-saving benefits.

Summary of Work Requirements in TANF, SNAP, and Housing Assistance Programs as of December 2017

This article was cross-posted at http://www.helpmlp.org

Affordable Care Act, Health Policy, Health Reform, Inequality, Medicaid, Pennsylvania, Social Determinants of Health, Uncategorized

Pennsylvania Lawmakers Move Forward with Medicaid Work Requirements

On April 16th the Pennsylvania House of Representatives voted to pass House Bill 2138 providing work requirements as a condition of receiving Medical Assistance (Pennsylvania’s Medicaid program). This bill is one of several currently making their way through the Pennsylvania legislature that would detrimentally affect low-income families and children, cost the state hundreds of millions of dollars to implement, and generally serve no valid public interest other than to deter individuals who need life saving benefits from getting them.

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House Bill 2138 mandates that Medical Assistance enrollees must work 20 hours per week or complete twelve “job training program-related activities” per month in order to maintain the benefit. Individuals who fail to comply with this requirement will lose their eligibility for three months initially, then six months, and then nine months. Individuals who are 19 years and older must verify compliance with the work requirements on a biannual basis and by request from the State. Furthermore, the State can delay enrollment if the individual is found to have failed to comply with these requirements.

Certain populations are exempt from the work requirements including: full-time high school students; individuals receiving temporary or long-term disability benefits; individuals under 18 years of age and 65 and over; pregnant women; individuals receiving Supplemental Security Income (SSI); primary caregivers for dependents six years of age or younger; and primary caregivers for individuals who are permanently disabled or in hospice care. Additionally, individuals who are experiencing a crisis, serious medical condition, or temporary condition that prevents the enrollee from actively seeking employment, including domestic violence and substance use disorder, are exempt.

The process in which individuals seeking exemption must participate in, including paperwork and verification requirements, is unclear based on the bill alone; however, the current Secretary of Human Services, Teresa Miller, reported that it would cost $650 million and an additional 300 staff members to enact these changes in her department. Now that the bill has passed the House, it moves on to the Pennsylvania Senate for a vote.

Policy experts find that work requirements harm families and individuals who are already working the most. Moreover, work requirements rarely lead to additional employment, but often lead to disenrollment, stripping vulnerable individuals of critical benefits and services. One study found, “four to five years after such requirements were implemented, about 70 percent of the welfare recipients who went off welfare because of work requirements had no income, or had income at or below 50 percent of the poverty line.”

Since the Centers for Medicare and Medicaid Services (CMS) changed its policy on work requirements in January 2018, Kentucky, Arkansas, and Indiana have had Medicaid waivers approved that include work requirements. Pennsylvania is among several other states in the process of establishing a pathway for work requirements.

It is critical that Pennsylvania residents and residents of other states seeking to implement these changes reach out to their elected officials urging them to stop their assault on poor families. The Pennsylvania Health Access Network has an easy form to find your State Senator and submit a letter urging her or him to vote NO on work requirements.

*This article was cross-posted on http://www.helpmlp.org.

Affordable Care Act, Health Policy, Health Reform, Inequality, Medicaid, Pennsylvania

Medicaid Expansion in Pennsylvania: Is it still possible?

budget letter photoToday, Pennsylvania Governor, Tom Corbett, announced his 2013-2014 proposed budget. During his budget address he announced that without further flexibility and reform from the federal government, expanding Medicaid in Pennsylvania would be, “financially unsustainable for Pennsylvania taxpayers”.  Governor Corbett’s announcement came a day after Republican Ohio Governor, John Kasich, announced that he would be expanding Medicaid in his state. Governor Kasich is the fifth Republican governor to do so.

While today’s announcement is certainly not good news for public health advocates, Corbett’s announcement did not entirely eliminate the possibility of expansion. In addition to his statement on the matter, Corbett sent a letter to HHS Secretary Sebelius identifying his concerns.

Corbett’s 2013-2014 proposed budget materials can be found here.

Uncategorized

Corbett’s Health Insurance Exchange Decision

Corbett’s Health Insurance Exchange Decision

Pennsylvania Governor, Tom Corbett, announced on December 12th that the Commonwealth will not be establishing its own Health Insurance Exchange. To most of us, this came as no surprise. Here’s the link to the Governor’s statement along with his letter to Secretary Sebelius. Within his letter, the Governor states his financial concerns of expanding Medicaid eligibility within the state. He cites to a $4 billion cost to the state over an eight year period. At this time the Governor has not decided whether Pennsylvania will expand Medicaid eligibility or not. 

Uncategorized

Regulations posted today on Federal Register

title=”Regulations posted today on Federal Register”>Regulations posted today on Federal Register

Today regulations have been posted by the Health and Human Services Department providing guidance on the Essential Health Benefits, Health Insurance Exchange and other provisions of the the Affordable Care Act. 

Affordable Care Act, Health Insurance Exchange, Health Policy, Health Reform, Pennsylvania

Pennsylvania State-Operated Health Insurance Exchange- Not Happening

PA Will Miss Health Insurance Exchange Deadline

On Wednesday, October 17, Pennsylvania Health Insurance Commissioner, Michael Consedine stated that the Commonwealth will not be meeting its November 16th deadline to submit an Exchange Blueprint to the Health and Human Services (HHS) Department. Because of this, the State will not be able to establish its own state-based exchange but must instead either default to a Federally Facilitated Exchange (FFE) or partner with the federal government to establish a Partnership FFE.

Affordable Care Act, Essential Health Benefits, Health Reform, Pennsylvania

Pennsylvania’s Essential Health Benefits Package Progress (or lack thereof)

Previously, I provided information about the progress of Pennsylvania’s Health Insurance Exchange (HIX) implementation.  Today I received an email from Pennsylvania Insurance Department (PID) Commissioner, Michael Consedine, providing an update on the Commonwealth’s developments with the Essential Health Benefits (EHB) package and other health reform issues.

In his email, sent out through PAHealthOptions.com, the Insurance Commissioner provided links to three documents that should inform the reader of the “most recent activities of the department.”  The links included: 1. A report conducted by Deloitte on the EHB in Pennsylvania; 2. A letter to the HHS Secretary regarding the EHB; and 3. A letter to the HHS Secretary requesting more information about HIX implementation.  Following the links Commissioner Consedine assured the reader that, “We continue to be committed to pursuing health care reform solutions that work best for Pennsylvanians – but we are similarly committed to making sound, informed decisions – not just fast ones.”

The Deloitte study analyzed the Commonwealth’s choices of existing plans within the state to operate as the EHB as provided by HHS.  These include: 1. The largest plan by enrollment in any of the three largest small group insurance products in the State’s small group market; 2. One of the three largest State employee health benefit plans by enrollment; 3. One of the three largest federal employee insurer options; or 4. The largest HMO plan offered in the State’s commercial market.

Deloitte found that there was only a one percent difference between the total value or cost between the highest and lowest options; however coverage differences did exist among the plans, most notably for dental and specialized services including behavioral health. The study also found that all ten of the existing plans analyzed would need to be supplemented in order to meet requirements under the Affordable Care Act (ACA).

So, the question is: Which health plan will Pennsylvania choose as its Essential Health Benefits package? Like the letter to HHS about the Health Insurance Exchange, Commissioner Consedine, provides a similar answer. The Commissioner states, “Given what we believe to be the clear statutory obligation on HHS to define EHBs and the lack of any rulemaking that would allow Pennsylvania to make an informed and consequential decision by September 30th, we are simply providing the study conducted by the Commonwealth at this time.”  Commissioner Consedine also stated in his letter that he will be “directing interested parties to submit their comments and recommendations to you [HHS] for your consideration. . . ..”

In an ironic attempt to subvert a “one-sized fits all” Washington D.C. policy on the State of Pennsylvania, the Insurance Department has chosen to defer to Washington D.C. to craft the EHB package and will most likely default to a Federally-Facilitated Exchange (FFE) or a Partnership FFE.