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

This month we remember Joseph “Joe” Campbell, the father of PHLP Co-Founder and Board Member, Michael Campbell, who passed away last month. We are saddened by Joe’s passing. He was a person of service throughout his lifetime, and especially believed in visiting and comforting the sick. We are also grateful that in lieu of flowers the family encouraged donations to PHLP.

The outpouring of support from friends of the Campbells has been tremendous. We are using the donations to provide legal advice and support to people in distress: people whose physical and mental well‐being are compromised by illness and who need help gaining health care coverage or getting the health care they need with their existing coverage.

This past spring, PHLP opened its 50,000th case counseling Pennsylvanians with health related needs and concerns. All services are offered free of charge.

It is a privilege to do this work, and we thank the Campbell family for helping to make it possible.

Protecting In-Home Skilled Nursing Care for Children

For many children and young adults with significant chronic illness, in-home skilled nursing care is essential. When parents have to work, they need trained, competent, and compassionate care givers who can be in their home to clean and adjust their children’s gastrostomy tubes for feeding, tracheostomy tubes for breathing, or intravenous lines to deliver medication. Such care keeps kids with their families and communities. But getting and keeping that type of care is not easy.

When Marie-Elaina learned that her 12-year-old daughter’s health insurer was dropping coverage for skilled nursing, she called PHLP.

Helen and her sister wait for the school bus.
Helen and her sister wait for the school bus. 
Helen had been receiving skilled nursing care for years. A nurse visited her home daily to clean and change her gastrostomy tube, which delivers nutrition and medicine directly to Helen’s stomach. This type of medical need requires skilled care. Failure could result in Helen’s hospitalization.  

PHLP immediately stepped in to represent the family. We worked with her medical provider to assemble documentation proving medical necessity. On the eve of the court hearing, the health insurer reversed its position and granted Helen’s family the necessary skilled nursing hours.

Marie-Elaina, Helen’s mother, later said, “This whole process can be so intimidating. I could never do all the research to know what [PHLP] knows … I don’t even know where we’d find legal advice otherwise. We are very appreciative of these services.”

PHLP Releases Resources on the End of PA Fair Care
On July 1, 2013, Pennsylvania’s Fair Care program ended and became the Pre-Existing Condition Insurance Plan (PCIP) run by the federal government until new, individual coverage under the Affordable Care Act begins January 1, 2014. PHLP has created a fact sheet on these changes. It is designed to help consumers explain the changes to their providers.

Monitoring the Transfers of Children from CHIP to Medicaid

Effective January 1, 2014, the Affordable Care Act changes eligibility rules, making children between ages 6 and 19 in households with incomes between 100-133 percent of poverty eligible for Medicaid, children who are currently eligible for the Children’s Health Insurance Program (CHIP). An estimated 50,000 children currently enrolled in CHIP are expected to transfer to Medicaid beginning January 2014. 

The issue of transferring children from the CHIP program to Medicaid coverage has raised concerns regarding continuity of care. In an effort to smooth the transition between programs, PHLP joined several partnering organizations to develop a detailed plan to ensure children move smoothly from one program to the other.

The plan was shared with the governor’s office and with the departments of Public Welfare and Insurance this month.  

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PHLP in The News

Pa. Justices to Weigh Who Can Appeal Autism Case Denials, Law 360, July 18, 2013

How Baby Erik Got Health Insurance, Philadelphia Inquirer, July 8, 2013

Meeting Helps To Get Facts Straight On Health Care, Philadelphia Tribune, July 3, 2013

What We're Reading

The Cost of Not Expanding Medicaid, The Kaiser Commission on Medicaid and the Uninsured, July 2013

The YouToons Get Ready for Obamacare: Health Insurance Changes Coming Your Way (creative production and animation), Kaiser Family Foundation, Released July 2013

Beyond the Basics: Health Reform’s Premium Tax Credits & Frequently Asked Questions, Center on Budget and Policy Priorities, July 2013

I Don’t Want To Be Part of The Welfare System: The Problem of Obamacare Enrollment, Sarah Kliff, WonkBlog, July 13, 2013

Pennsylvania … Turning Over High-Risk Insurance Pool Responsibility to Feds, WHYY, July 1, 2013

Subsidy Calculator to estimate beneficiaries' share of annual premiums and cost sharing in the health marketplaces based on their income, household size, age and tobacco usage, Kaiser Family Foundation

Upcoming Trainings & Conferences

Free PHLP training on New HealthChoices Zones, July & August 2013

Pennsylvania Health Access Network’s 5th Annual Conference in Harrisburg, September 22-23, 2013

2013 CMS Health Insurance Marketplace Workshop in Philadelphia, September 24, 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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