Access to affordable, quality health care is a key component to economic security for women and their families. Data shows that when people have that access, there is economic growth, improved productivity, and better learning by students … all of which benefits our community, state, and nation. Access to health care should be a right for everyone without fear of financial hardship when paying for it. Other industrialized nations around the word recognize that and it is beyond time that we embrace that principle as well.
Unfortunately, there are political forces that continue to attack various parts of our vary complex, anything but seamless, health care system … a system that was developed over a period of a hundred years in stages … first employer-based private insurance for some workers, then Medicare senior coverage, Medicaid coverage for low income, CHIP coverage for children, and Medicaid Expansion (in only 31 states plus D.C) and the individual marketplace that the Affordable Care Act (ACA) finally addressed. Each program makes up the patchwork whole of our U.S. Health Care System that is the most expensive in the world and still we have 11.7% uninsured.
Through Medicaid and Medicaid Expansion, poor and low-income women can have access to family planning (think contraception) and preventative care to avoid long-term poverty and life-long debt for themselves and their children. Contraception coverage without co-pay is a critical and essential health benefit. We must be sure that Planned Parenthood continues to receive Medicaid reimbursement for the trusted health care and services they provide each year to over 2.4 million women and men.
The ACA needs continued advocacy.
While we held off repeal and replace this summer, efforts to sabotage the ACA are still being done by Congress through proposed cuts in the US budget and the Executive Branch regulation oversight within the Department of Health and Human Services.
An example of this sabotage effort is the recent announcement by the Department of Health and Human Services that marketing budgets for this fall’s open enrollment were slashed by 90%, and in-person outreach, education, and assistance budgets were slashed by 43%. The Administration had already cut the timeframe for open enrollment in half from 3 months to 6 weeks. Annual health insurance enrollment can be a daunting task for everyone but with a much shorter time to apply and less help available, it will be a barrier many can’t navigate.
The 2018 Open Enrollment runs from November 1, 2017 to December 15, 2017. Outside the Open Enrollment Period, you generally can enroll in a health insurance plan only if you qualify for a Special Enrollment Period.
As advocates, we must stay vigilant to these kinds of undercutting efforts and highlight the harm they will inflict on real people’s lives. Stories are important to collect and tell to all our elected officials.
CHIP up for reauthorization.
CHIP (Children’s Health Insurance Program) is one overlooked but critical insurance program designed for children of working families with low to moderate incomes. First introduced in Pennsylvania then authorized in 1997, the Children’s Health Insurance Program (CHIP), funded jointly by the federal and state government, must be reauthorized by Congress by September 30, 2017.
Since states do not know if Congress will continue funding CHIP or also include a needed 23% funding increase, many states are developing contingency plans. Yet, Pennsylvania, like most states, has already enacted their spending budgets for their current fiscal year and will likely not have a plan or the revenue to make up for any loss of CHIP funding.
The Center for Medicare and Medicaid Services (CMS) outlined several options for transitioning children to other coverage: 1) phase out CHIP and transition children to either Medicaid or exchange coverage; 2) move children to a Medicaid expansion CHIP program; or 3) establish a combination of these approaches. All of these options would require states to devote considerable planning, coordination and financial resources, and time is running out.
In 2014, 89.5% of eligible Pennsylvania children participated in either CHIP or Medicaid, and of these, 96.7% of the children aged 12-24 months and 91% of teens 12-19 years visited a primary care provider. In addition to general medical and dental benefits CHIP covers services that are extremely important for children, such as vision exams and corrective lenses, physical and occupational therapy, speech, language and hearing services and inpatient and outpatient behavioral health services. These additional benefits are not necessarily available through employer sponsored or other insurance plans, especially at a cost that is affordable to these families.
If CHIP coverage is no longer available because it is not reauthorized, children will be at risk for losing health insurance coverage and will have difficulty accessing appropriate services. This would be particularly tragic for children with special needs and teens who need treatment for opioid abuse.
The Pennsylvania’s Medical ACCESS program, developed in 1992 under Medicaid, has been a lifesaver for many families with special needs children to give them the services they need in schools. Unfortunately, under proposed legislation in Washington, Pennsylvania could lose more than $143 million in federal funding now provided under the Medical ACCESS program with the Bucks County IU targeted to lose more than $3million. Local schools will not be able to afford the special education to children with disabilities that they are legally required to provide, according to the Bucks County IU.
Pennsylvania legislature also attacking our health care system.
While most Americans are focused on the federal level of our government, we must not overlook for a minute what is happening in Harrisburg and the attempts there to undermine women’s health care and Medicaid.
HB59 is currently before the PA House. HB59 would force nearly a million adults through state government hoops to verify their employment or exemptions, taxing an already overburdened system and wasting critical resources that will do little to increase workforce participation. In addition, HB 59 opens the door for cuts on “nonessential” benefits such as dental, vision, and prescription coverage to those who need it most.
Additionally, two anti-abortion bills that would outlaw a safe medical procedure and shorten the timeframe when a legal abortion could be requested (SB3/HB77) are moving through the PA Senate and House. SB3 narrowly passed the PA Senate and sits in the House Health Committee. On top of that, two PA Planned Parenthood “defunding” bill (SB300/HB1542) are also expected to pick up speed again this fall. SB300 is up for third consideration in the PA Senate if it is released from the Appropriations Committee. These bills would have harmful impacts on women and their health care.
I urge you to follow our BCWAC advocacy efforts through the bi-weekly call-to-action that you get conveniently in your email box if you are a Partner or you can find it here on our website. Join us. Make your voice heard. Together we can overcome the challenges of today for a brighter, healthier future for women and their families.
If we have learned anything over the last 8-months, it is that our stories, calls and visits do matter. Our goal as a nation should be that all people have the opportunity to thrive. Systemic barriers to access our health care systems should be eliminated so that all may contribute to their maximum ability … and that really will make our country greater.Medicaid and Medicaid Expansion
Tam St. Claire is President of the Bucks County Women’s Advocacy Coalition.