Cover the Commonwealth by Expanding Medicaid

Pennsylvania’s recent track record on healthcare for the poor has restricted rather than promoted health and well-being for the most vulnerable. There is now an opportunity to reverse that trend through expansion of the Medicaid program.

There are currently more than 1.3 million uninsured in the Commonwealth. Accepting the opportunity to expand the  Medicaid program will bring coverage to as many as half a million new people earning 133% of the Federal Poverty Level, or about $15,000 a year. Advocating for this expansion builds on our church’s front line work in providing health services in our neighborhoods, our awareness of the devastating impact that loss of health care has on the well-being of individuals and families and is consistent with our church’s commitment to working towards health care distributed on the basis of need rather than ability to pay. LAMPa is calling for its network to get involved in bringing this change.

First,  a little history. The adultBasic health insurance program for the working poor was closed two years ago, despite vigorous advocacy by LAMPa and other groups. At that time, an ELCA Seminarian shared that she had gotten involved because her in-laws were among the 42,000 who relied on adultBasic. Without it, she said, they had no access to preventative or necessary services. Since adultBasic’s demise,  few have taken advantage of the wildly inadequate and expensive Special Care program that took its place. Last year, the Department for Public Welfare cut more than 150,000 people – including 43,000 children – from medical assistance in a drive to save costs and “reduce fraud”. This purge was challenged, and many who were wrongfully removed are now being reinstated.  But many still remain without access to health care.

Despite the many funding decisions leaked in advance of the Governor’s budget address, the future of expanding Medicaid under the Affordable Care Act remained uncertain until Tuesday. In his remarks, the Governor appeared to close the door on the issue, although not entirely shut it. He referred in his speech to a letter just sent to Health and Human Services Secretary Kathy Sibelius, advising that “at this time, without serious reforms, it would be financially unsustainable for the taxpayers and I cannot recommend dramatic Medicaid expansion.” He reported that state estimates show “a Medicaid expansion would cost Pennsylvania almost $1 billion of new state taxpayer dollars through fiscal year 2015-2016, ultimately rising to a total cost of over $4.1 billion of new state taxpayer dollars by the end of fiscal year 2020-2021”. He concluded, “We cannot afford to expand a broken system,” and that “the cost to maintain our current Department of Public Welfare programs will increase by $400 million dollars” citing as the main drivers of that increase – “Medicaid and long-term care.”

An expanded Medicaid will bring costs to the state after the first several years. But in our analysis, it will cost far more not to accept the opportunity, as six other Republican Governors have now done, most recently in Ohio and Michigan. The majority of the cost will be borne by the Federal Government – one hundred percent for the first three years and 90% of costs thereafter. An expanded Medicaid would inject an estimated $38 billion into Pennsylvania’s economy, creating by some estimates hundreds of thousands of health care jobs and a stimulus that could help fund future Medicaid costs. Although the Hospital Association has remained neutral on the issue, expanding coverage would also prevent hospitals from losing more than $1 billion per year in federal uncompensated care.

LAMPa is advocating the expansion of Medicaid in order bring health care to working Pennsylvanians who make up to 138% of the Federal Poverty Level, enabling them to access preventive care instead of expensive emergency room treatment. We know this kind of access is a vital component in paving a pathway out of poverty and promoting human dignity. It is also a direct application of the command to love our neighbor and actively provide for our neighbor’s well-being.

The Governor has left a crack in the door for expanding Medicaid coverage. We will be working in that small space to open the door to cover the Commonwealth.

Find the PA Health Access Network Medicaid Toolkit here.

See the State of PA web page on Federal Health Reform.

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