Monday, October 7, 2013

Notes from the 2013 Pennsylvania Health Access Network Conference

I am grateful to the folks at PHAN for pulling together an informative conference for PA advocates, providers, and public health wonks like me. We mostly talked about health reform and the Affordable Care Act, with enrollment starting on October 1. Here are some of my notes and impressions. I would love to hear from others who attended.


The conference theme of Cover the Commonwealth informed the whole day's programming. We talked and talked about health reform in PA, including Gov. Corbett's proposal to reform (and expand) Medicaid, Healthy Pennsylvania. We also discussed how to talk to people about health reform and new coverage options. I wrote a separate post about communication tips. You can see all the tweets from the conference at #PHAN13


Navigators and Certified Application Counselors


Every type of community organization and health care provider is encouraged to have Certified Application Counselors on staff to help individuals and families enroll in the Marketplace. You can find out how to become a Certified Application Counselor organization here. Keep in mind that there will be a delay between application and approval from CMS, I have heard 30-60 days. 

Three of the federally-funded Navigator organizations were on hand to talk about their plans to help enroll every eligible Pennsylvanian. They have some big goals and are going to need help to reach them. These organizations want to work with your CBO or community group, so contact them to set up a time for their navigators to come and help enroll your clients/members.

Resources for Human Development is focusing on the 10 PA counties with the most uninsured people. Philadelphia County has the most uninsured of any county (and the most people). 

Pennsylvania Association of Community Health Centers (PACHC) will support all the Navigators and Certified Application Counselors in the state. 

Mental Health Association of Pennsylvania will also have Navigators in the community throughout the state ready to help enroll people in the Marketplace. 

Medicaid

In mid-September, Governor announced his Medicaid reform plan, Healthy Pennsylvania. All we know about the reforms are contained in the concept paper, about 10 pages. So the details are unknown. Included in these reforms would be coverage for low income adults, regardless of health or disability status, essentially it is Medicaid expansion by another name. I can share with you my initial impressions and some of what I learned at the conference. Please remember that this is just a proposed plan, not a reality. The Governor must submit a Medicaid waiver application to the federal government for approval, which will take at least several months. At this point in time, Medicaid is going to work as it has, nothing new for the short term.

Proposed Medicaid reforms include requiring working-age, non-disabled recipients to actively looking for employment and/or enroll in a job training program. This kind of requirement is not allowed under current Medicaid law and is a big task to oversee and administer. Some people are thinking this could be a roadblock to federal approval.

Gov. Corbett would like to remove all co-pays associated with Medicaid coverage and start requiring a monthly premium (bill) based on income, no more than $25/month for an individual or $35 for a household. Many people would pay no premium or very little. 

With these reforms, Gov Corbett argues the state would be able to include more people in Medicaid, including low income adults. These newly-eligible recipients would be enrolled in the insurance Marketplace and given state/federal subsidies to pay for insurance just like other Pennsylvanians buying insurance through the state marketplace. These individuals/families would also be required to pay a monthly premium based on income. The will also have a choice to select a Marketplace plan or the Health Choices plans. 

Other items in the concept paper include a penalty of $10 for "inappropriate use" of the Emergency Room, reduction in the number of benefit packages offered to different categories of Medicaid enrollees from 14 to 2, and no changes to children's benefits under Medicaid/CHIP.

I encourage you to sign up for the PHAN newsletter to keep up to date on all the training and events they offer. They will be a great resource for health reform in PA. A member of PHAN will come to your organization to educate your clients or staff. You can also participate in webinars and conference calls.


Nicole Johns is a senior health planner at the Office of HIV Planning. You can also find her on Google+.

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