The Law Center joined a group of 142 organizations in calling on Pennsylvania Senators Pat Toomey and Bob Casey to protect Medicaid.
The letter expresses our strong opposition to legislative proposals, such as the American Health Care Act (AHCA), that would cause millions to lose their health care.
The letter states:
The AHCA is bad policy for children and would result in tens of thousands of Pennsylvania’s children whom are living at or near the poverty level to lose their Medicaid coverage. With 43 percent of Medicaid enrollees in the commonwealth being children, the program ensures that children who are identified with possible delayed or impaired development receive the services they need to become healthy adults. With the AHCA making essential health benefits a state option, the pediatric and preventative services children sorely need, including oral and vision care, could go away.
We are urging the Senators to oppose any legislation that would cap federal Medicaid payments to the states or end the Medicaid expansion.
Full letter:
June 15, 2017
Dear Senator Toomey and Senator Casey:
Our organizations write to express our strong opposition to legislative proposals, such as the American Health Care Act (AHCA), that would cause millions to lose their health care. In particular, we are deeply troubled by proposals that would undermine state Medicaid programs by capping federal funding on a per capita (or block grant) basis and phase out the Affordable Care Act’s Medicaid expansion.
For more than 50 years, the federal government has matched state Medicaid spending on health and long-term care for low-income children, parents, women, seniors, people with disabilities and other vulnerable populations. Medicaid has been a resounding success, providing cost-efficient and high quality health care to our state’s most vulnerable citizens. In fact, a 2016 national survey by the Commonwealth Fund found that Medicaid beneficiaries are just as likely to have a regular health care provider as those with private coverage and they rate the quality of care more highly than those with private coverage.
A critical component of Medicaid’s success has been the guaranteed federal payment match, which automatically adjusts to help states respond to public health crises and other factors that drive up health care spending. But under a capped payment system, our state would be on its own to manage higher costs. For example, our state could not count on increased federal funds to address a Zika outbreak or a worsening of the opioid epidemic. Our state could not count on increased federal funds to help grapple with higher costs due to treatment breakthroughs as experienced with the development of drugs for HIV/AIDS and more recently with hepatitis C. States with increasingly older senior populations like Pennsylvania would be on their own to manage the higher health costs resulting from such a demographic trend.
Under a per capita cap (or block grant), Pennsylvania would be forced to make up for the loss of federal support by narrowing eligibility, cutting health care services, reducing payments to providers or, more likely, all three. Because services for low-income older Americans and people with disabilities are costly, it is likely that they will be a focus for state spending cuts. Home care services are especially at risk since they are an optional service under Medicaid.
Once restructured, federal Medicaid payments would be at frequent risk of being reduced, or dialed down, in order to pay for tax breaks or other federal spending. This concern is validated by the budget proposed by President Trump which would further ratchet down per capita cap payments to states. This would upend the federal-state partnership and create even more uncertainty for budget planning in the state.
The AHCA is bad policy for children and would result in tens of thousands of Pennsylvania’s children whom are living at or near the poverty level to lose their Medicaid coverage. With 43 percent of Medicaid enrollees in the commonwealth being children, the program ensures that children who are identified with possible delayed or impaired development receive the services they need to become healthy adults. With the AHCA making essential health benefits a state option, the pediatric and preventative services children sorely need, including oral and vision care, could go away. Many early intervention and special education services required to be provided by Pennsylvania school districts that rely on Medicaid as a source of funding would be in jeopardy, driving schools to increase local property taxes to provide them. In addition, the Early and Periodic Screening Diagnostic and Treatment component of Medicaid, more commonly referred to as EPSDT, would be threatened. EPSDT ensures children, particularly those with complex needs, receive the check-ups and treatments they need.
We are also strongly opposed to the phase-out of the ACA’s Medicaid expansion under AHCA or any other proposal. More than 703,000 Pennsylvanians have gained Medicaid coverage through the expansion. These individuals, and those who become eligible in the future, are likely to lose this coverage once the enhanced federal match is ended. Proposals to phase out the expansion more slowly do very little to mitigate the ultimate harm of ending coverage for these low-income adults, many of whom work in low-wage jobs that do not provide insurance. This is especially true in rural areas where low-wage jobs are less likely to provide health coverage than jobs in urban areas.
We also caution you to consider the impact of Medicaid cuts on the state’s economy. The Medicaid program is a critical part of our health care infrastructure. There is no doubt that withdrawing $834 billion from health care over the next ten years will have a significant impact on health care employers and on the jobs they provide. The economic impact will be especially harmful in rural communities where hospitals and other providers are often the largest employers in the community.
For all of these reasons, we urge you to oppose any legislation that would cap federal Medicaid payments to the states or end the Medicaid expansion.
Sincerely,
ACLU of Pennsylvania
Action Together NEPA
AFSCME DC47
AIDS Law Project of Pennsylvania
All About Children Pediatric Partners, PC
Allegheny Intermediate Unit
Allies for Children
American Academy of Pediatrics, PA Chapter
Amy Requa Health Consulting, Inc.
APRI Philadelphia Chapter
Arc of Greater Pittsburgh/ACHIEVA
Art As Social Inquiry
Back Mountain Free Clinic
Bryn Mawr Peace Coalition
Bucks County Citizens for Health
Bucks County Women’s Advocacy Coalition
ButlerPA Indivisible
CASA of Philadelphia
Catherine McAuley Center
Catholic Social Services Scranton
Chester County Fund for Women and Girls
Children’s Hospital of Philadelphia
Clinician Action Network
Communications Workers of America 2-13
Community Check-Up Center
Community Health and Dental Care
Community Intervention Center
Community Legal Services of Philadelphia
Community Resources for Independence
Consumer Health Coalition
Crozer-Keystone Community Foundation
Delaware County Women’s Center
Dignity Housing
Disability Options Network
Disability Rights Pennsylvania
Education Law Center-PA
Emmaus Community of Pittsburgh
Face to Face
Family Practice &Counseling Network
For Pennsylvania’s Future
Free Clinic Association of PA
Friends Rehabilitation Program, Inc.
Genuardi Family Foundation
Give a Smile
Greater Philadelphia Coalition Against Hunger
Health Federation of Philadelphia
Health Professionals and Allied Employees
Healthy Philadelphia
HELP: MLP at Widener University Delaware School of Law
HIAS Pennsylvania
Homeless Advocacy Project
IHM Sisters, Immaculata
Insulators Local 14
Jefferson Regional Foundation
Jewish Social Policy Action Network
Juvenile Law Center
Keystone Progress
Lebanon Family Health
Legal Clinic for the Disabled
Linda Creed Breast Cancer Org
Lutheran Advocacy Ministry in PA
Machinists 1776
Maternity Care Coalition
Mazzoni Center
Mental Health Association in Pennsylvania
Mental Health Partnerships
Montgomery County Intermediate Unit
NAMI Keystone PA
National Physicians Alliance Pennsylvania
Nationalities Service Center
Nazareth Housing Services
One Pennsylvania
Pennsylvania Association of Community Health Centers
Pennsylvania Association of School Nurses & Practitioners
Pennsylvania Breast Cancer Coalition
Pennsylvania Chapter of the American Academy of Pediatrics
Pennsylvania Chiropractic Association
Pennsylvania Coalition for Oral Health
Pennsylvania Head Start Association
Pennsylvania Health Funders Collaborative
PathWays PA
Pennsylvania Association of Staff Nurses and Allied Professional
Pennsylvania Budget and Policy Center
Pennsylvania Council of Churches
Pennsylvania Federation BMWED-Teamsters
Pennsylvania Health Access Network
Pennsylvania Health Law Project
Pennsylvania National Organization for Women
Pennsylvania Partnerships For Children
Pennsylvania State Council of Machinists
Pennsylvania Statewide Independent Living Council
Pennsylvania Utility Law Project, on behalf of our low-income cl
People’s Emergency Center
Philadelphia Chapter of the Coalition of Labor Union Women
Philadelphia Council AFL-CIO
Philadelphia Unemployment Project
Philadelphia VIP
Pittsburgh Association for the Education of Young Children
Pittsburgh Center for Autistic Advocacy
Planned Parenthood Association of PA
Planned Parenthood Keystone
Planned Parenthood of Western Pennsylvania
Planned Parenthood Southeastern PA
POWER Northeast
POWER Philadelphia
PRO-A
PRO-ACT Public Policy Committee
Project HOME
Public Citizens for Children and Youth
Public Interest Law Center
QCHC
ReMed
Resources for Human Development, Inc.
Salisbury Behavioral Health
SEIU Healthcare Pennsylvania
Self Determination Housing Project
Senior Law Center
Southeast Lancaster Health Services
Southwest PA ADAPT
SpArc Philadelphia
Support Center for Child Advocates
Temple Association of University Professionals
The Arc of Adams County
The Arc of Cambria County
The Arc of Chester County
The Arc of Crawford County
The Arc of Dauphin County
The Arc of Erie County
The Arc of Jefferson & Clearfield Counties
The Arc of Lancaster County
The Arc of NEPA
The Arc of Pennsylvania
The Arc of Philadelphia
The Arc of Washington County
UAW Region 9
UFCW 1776
Visiting Nurse Association-Community Services
Voice of Westmoreland
Women’s Law Project
YWCA Greater Pittsburgh
