Pennsylvania Health Law Project: Helping People in Need Get the Health Care They Deserve

Beyond the Numbers: Why Health Coverage Matters

Imagine waking up in the middle of the night, gasping for breath and your heart pounding so fast you cannot count your pulse. You need medical help but think “what will happen if I go to the emergency room? I don’t have insurance, and I can’t afford the bill!” This happened to Hope, one of the thousands of callers to PHLP’s Helpline who needs health insurance. Hope went to the emergency room, was admitted to the hospital, and sent home on expensive medications. Her specialists told her to make appointments when she had health insurance. Hope’s story is one of several in Uninsured Pennsylvanians, PHLP’s chronicle of the personal struggles of Pennsylvanians who have little or no health insurance coverage. Their stories remain relevant as Pennsylvania lawmakers debate whether to extend Medicaid eligibility to hundreds of thousands of uninsured Pennsylvanians, with the federal government covering the full cost.
Uninsured Pennsylvanians is a first-hand look at the daily difficulties people without health insurance face and the reasons they do not have health coverage. These stories illustrate the importance of securing health insurance. Domenic, for example, worked for more than 40 years until he was laid off and lost his employer-sponsored health insurance. He never thought he would need government assistance but, as a taxpayer, he believed help would be there for him. “I’m looking for a little bit of help, not a long term handout,” he said. Domenic discovered the current reality: a working adult without a child or a disability is not eligible for Medicaid. Without insurance to pay for his medications, Domenic lost three toes. They were amputated after he developed a serious infection due to his untreated diabetes. 
Stories like Hope and Domenic’s get us beyond the numbers. The uninsured are our neighbors, living every day with illness and fear —fear of getting sicker, fear of losing their homes due to unpaid medical bills, fear of acknowledging a serious health problem only to be faced with the staggering costs of treatment. The health care status quo must change.

New PHLP Publications Detail Benefits and Savings Created by Expanding Medicaid

Pennsylvania lawmakers have an unprecedented opportunity to improve the lives and health of hundreds of thousands of uninsured Pennsylvanians, with the federal government covering the full cost. PHLP released several analyses to inform the public and state policy makers about this decision.
Together, these analyses emphasize how expanding Medicaid is the right decision, both for Pennsylvania’s budget and for Pennsylvania’s families and communities. We encourage readers to review each of these reports at our website and to share them widely. The complete series can be read or downloaded from PHLP’s website.

PHLP Preparing Comments to Federal Government’s Proposed Rules on Medicaid Eligibility

On January 14, 2013, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule and fact sheet on Medicaid eligibility, covering the coordination of notices and appeals, certification of application counselors, the Medicaid benefits package for the newly eligible adult population, changes to cost-sharing in Medicaid, and state options for determining Medicaid eligibility during the initial exchange open enrollment period. Comments are due on February 13, 2013.  PHLP is analyzing the proposals and will submit comments.

PHLP Website Interruption

Recently, our website was intermittently down due to technical difficulties. We worked with our carrier to address this problem as quickly as possible and believe everyone should now be able to access our website. We apologize for any inconvenience.  If you are unable to access our website, please let us know.  Thank you for your understanding. 
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Advocates are collecting stories from Pennsylvanians who lost General Assistance benefits last year. To learn more visit PA Cares for All or contact The Family Training and Advocacy Center by phone (855-278-0031) or email.

What We're Reading

Video: Using the Online Single Streamlined Application, Centers for Medicare and Medicaid Services, January 25, 2013 

Getting into Gear for 2014: Findings From a 50-State Survey of Eligibility, Enrollment, Renewal and Cost-Sharing Policies in Medicaid and CHIP (ranks PA as least prepared), The Kaiser Family Foundation, January 22, 2013

Implementing Health Reform: Medicaid And Premium Tax Credit Eligibility And Appeals (Part I), Health Affairs Blog, January 15, 2013

Implementing Health Reform: Medicaid And Premium Tax Credit Eligibility And Appeals (Part II), Health Affairs Blog, January 16, 2013

Support for Medicaid Expansion Growing Among Governors of Both Parties, Center on Budget and Policy Priorities, January 16, 2013

State Medicaid Director Letter on the Application of the Mental Health Parity and Addiction Equity Act to Medicaid MCOs, CHIP, and Alternative Benefit (Benchmark) Plans, Centers for Medicare and Medicaid Services, January 16, 2013

The 2013 New Year's Budget Deal and Medicaid: The Next Cliff, Families USA, January 2013

Designing Consumer-Friendly Health Homes, Families USA, January 2013
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The Pennsylvania Health Law Project is a nationally recognized expert and consultant on access to health care for low-income consumers, the elderly, and persons with disabilities. PHLP engages in direct advocacy on behalf of individual consumers while working on the kinds of health policy changes that promise the most to the Pennsylvanians in greatest need.
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