Transforming Health: CHIP and the ACA

Written by Matt Paul, Reporter/Producer | Jan 30, 2014 4:00 AM

(Hershey) -- Pennsylvania's Children's Health Insurance Program is at the center of the latest flap over the federal Affordable Care Act, as thousands of families are being transitioned from CHIP to Medicaid.

Congressman Charlie Dent doesn’t think any family should be forced to change programs. "This is another classic example of the problem that continues to plague the health care law -- if you like your plan, you can keep it," he noted during a recent stop at the Penn state Hershey Medical Center.

The midstate Republican is concerned about an ACA provision that mandates all children in families between 100 and 133 percent of the federal poverty level be enrolled under Medicaid. That's roughly between $23,000 and $31,000 for a family of four.

The transition was supposed to begin on January first, but months of correspondence between the Corbett administration and the U.S. Department of Health and Human Services yielded a temporary reprieve. About 30,000 Pennsylvania families are now being given the option to keep their CHIP coverage until their next scheduled renewal, but they must still be Medicaid-enrolled by 2015.

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Rep. Charlie Dent

Dent visited Hershey to unveil legislation designed to make the option permanent, because he says CHIP provides far better access to physicians, hospitals and medical providers.

But many advocates for low-income families think otherwise. Richard Weishaupt, a senior attorney at Community Legal Services of Philadelphia, says access won't be an issue for most families.

“In most big cities and rural areas the same panel of doctors accepts both Medicaid and CHIP," he says. "If there are particular problems with doctors not accepting Medicaid, the solution is probably better to talk to those doctors and sign them up for Medicaid."

But Governor Corbett, who's currently negotiating a Medicaid overhaul in Pennsylvania, supports Dent's bill. He says no child should have to lose access to his or her doctor because of a one-size-fits-all plan coming from Washington D.C.


Dr. Hillemeier

"We have a good friend who was a pediatrician, he's retired now. Our kids went with him from birth until they were 18. You develop a doctor-patient relationship that you want to keep and you don't want to keep changing," Corbett explained.

That's the message continually resonating in the letters health systems and doctors' groups have sent HHS Secretary Kathleen Sebelius.

Dr. Craig Hillemeier, who chairs the Department of Pediatrics at Penn State Hershey, was among the signatories.

“I think that what people are saying is that, especially, children who are dealing with serious medical problems have enough going on that they should not have to pay attention to those kind of obstacles," he says.

But in her written responses, Secretary Sebelius contends the transition from CHIP to Medicaid will simplify coverage for these low-income families.

The Commonwealth's existing system has multiple income guidelines. For instance, a hypothetical family of four earning $30,000 would have to enroll their children in Medicaid until age six, when they transition to CHIP.

The Affordable Care Act seeks to have all members of a low-income family eligible for the same program.

Attorney Richard Weishaupt says the transition won't just streamline health coverage for these families, but Medicaid will also provide them with a better package of benefits.

"In Pennsylvania, Medicaid provides better behavioral health services for children who have mental health or cognitive disabilities, as well as older children who may have involvement with drugs," he says. "In addition the Medicaid program provides transportation because a lot of children who need health care services also need transportation to get to and from the doctor or their other treatment facility."

More than one million children are enrolled in Pennsylvania's Medicaid program -- vastly more than CHIP. But no matter which program these children wind up in when the political wrangling is over, the majority of CHIP enrollees are unaffected by the ACA. CHIP coverage, which is now in its 22nd year, will continue for tens of thousands of other kids with family incomes between 133 and 300 percent of poverty.

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