Alert: Healthy PA Comments Are Due January 13

Alert for the Disability Community:

Healthy Pennsylvania Comments Due January 13

 

The Department of Public Welfare is proposing “Healthy PA,” which is not simple Medicaid expansion.  Healthy PA would (1) cut benefits for adults on Medicaid (Medical Assistance), and (2) provide private insurance coverage for other uninsured adults, without the rights and protections of Medicaid.  The Draft 1115 Waiver application can be found here.   The Pennsylvania Bulletin notice can be found here.

 

Healthy PA would affect people with disabilities, and so it is very important for people with disabilities to submit comments.

 

Comments are due this Monday, January 13.  Email comments to ra-PWHealthyPA1115@pa.gov or mail them to:  Department of Public Welfare, Attention:  Healthy Pennsylvania Waiver, P.O. Box 2675, Harrisburg, PA 17105-2675.  Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at 800-654-5984 (TDD users) or 800-654-5988 (voice users).  Every comment matters.

 

Big changes are being proposed, which include:

 

• Cutting Medicaid benefits for adults ages 21 to 64.  Durable medical equipment and medical supplies would be limited to either $1000 or $2500 a year.  This does not cover a new power wheelchair and other equipment.  Outpatient mental health visits would be limited to either 30 visits or 40 visits a year.  This is not enough for weekly therapy.  Radiology, laboratory work, inpatient acute and psychiatric hospitalization, and other services would be limited.

 

• Covering other adults, up to 133% of the federal poverty level, through private insurance.  This would be called the Private Option.  For people in the Private Option, there would be no Fair Hearings for coverage denials, no Medicaid transportation or other Medicaid wrap-around benefits, virtually no ability to get out-of-network services, no Medicaid medical necessity standard, and no retroactive coverage.

 

• Medical Assistance for Workers with Disabilities would end.

 

• People in Medicaid and in the Private Option who have incomes above 50% of the federal poverty level would have to pay monthly premiums.  50% of federal poverty level is $479 income per month for an individual or $981 income per month for a family of four.

 

• Work requirements would be in place for those on Medicaid and those in the Private Option.

 

For more information, go to DRN’s overview of Healthy PA.

 

Contact: Kelly Whitcraft, DRN Policy Coordinator, at kwhitcraft@drnpa.org or 800-692-7443, extension 323.