Legal Aid to Preserve Children's Health Insurance
For many low-income families, a change in household earnings means children transfer between Medical Assistance (MA) and Children’s Health Insurance Program (CHIP) coverage. Although Pennsylvania has an automated referral process to keep health coverage in place, sometimes that process fails and families lose coverage through no fault of their own. PHLP helps families overcome these coverage gaps.
”Mr. Jacobs”, a disabled single dad from Philadelphia County, reported a change in his disability income to the County Assistance Office (CAO). He was told that his 17-year-old daughter, “Kelsey,” no longer qualified for MA, but that an application for coverage would be forwarded to CHIP.
Months went by and Mr. Jacobs did not hear anything. He called the CAO several times, who assured him the automated process would work – yet Kelsey remained uninsured.
Then, Kelsey fell ill and was admitted to the hospital for four days. Without insurance, Mr. Jacobs was told he would need to pay over $60,000 to cover the bill. He knew he could not afford a bill that large on his limited disability income, so Mr. Jacobs called PHLP.
PHLP gathered evidence, contacted state officials, and explained what happened. The state agreed to enroll Kelsey in MA coverage immediately, and made that coverage retroactive so that the hospital bill could be paid in full.
Mr. Jacobs was relieved the hospital bill was taken care of. He explained, “I knew there was something wrong with how this happened, I just couldn’t figure out how to explain it or find the right person to explain it to.” PHLP is glad that the family got the relief they deserved.
PHLP Co-Convenes Conference on What the ACA Means for People with Jail Stays
Compared with the general public, people who populate jails have higher rates of communicable diseases such as HIV/AIDS; tuberculosis; mental illness and substance abuse disorders; and chronic conditions, including asthma, diabetes, and Hepatitis C. For this population, access to medical treatment upon release is extremely important, yet most have been returning to the community without health coverage
When fully implemented, the Affordable Care Act (ACA) will reduce financial barriers to coverage for people released from jails, through Medicaid expansion and subsidized insurance Marketplaces.
This month, PHLP co-convened representatives of fourteen counties to discuss what federal health reform means for people with jail stays. Co-conveners included the Pennsylvania Departments of Corrections and Public Welfare and the County Commissioners Association of Pennsylvania
. County attendees heard presentations about new coverage opportunities, and what counties can do in the near term to take full advantage of the ACA and of the January 2015 Medicaid expansion envisioned by Governor Corbett’s Healthy PA proposal.
PHLP Project Fellow Maureen Barden is available to help counties address these issues. Contact her at email@example.com
or (215) 287-4238. Maureen’s fellowship, through a grant from the Open Society Foundation
, aims to ensure re-entering individuals have health insurance coverage and that this coverage translates into meaningful access to care.