CLS advocates for fair Health Insurance Exchange

August 15, 2011

On August 11, CLS Staff Attorney Kristen Dama provided the following testimony at a forum convened by the Pennsylvania Insurance Department regarding how to best implement Health Insurance Exchanges in Pennsylvania.  

Community Legal Services (CLS) thanks Commissioner Michael F. Consedine and the Pennsylvania Insurance Department for hosting public forums to permit stakeholders to present ideas on the establishment of a Health Insurance Exchange in Pennsylvania.

For more than forty years, CLS has helped thousands of low-income Philadelphians with legal problems by providing them with advice and representation in non-criminal cases, advocating for their legal rights, and conducting community education to inform them about the laws that affect their lives.  CLS also engages in legislative and administrative advocacy on behalf of its clients.  CLS’s Public Benefits Unit works to ensure that low-income Philadelphians have access to public health insurance and other benefits.

In recent months, CLS has been happy to work with the Pennsylvania Health Access Network, a statewide coalition of organizations working to protect high quality health insurance coverage and to expand coverage to the uninsured, to develop a Joint Position Statement for Implementing a Health Insurance Exchange.  The Position Statement outlines recommendations for establishing a Pennsylvania-run Exchange that functions as a marketplace for affordable, accessible coverage for individuals and families.  Rather than reiterate the principles contained therein, we simply note our endorsement of the Position Statement and urge Pennsylvania to incorporate its principles if and when it establishes a state-run Exchange.

CLS believes that implementation of the Affordable Care Act (ACA) creates an unprecedented opportunity to provide comprehensive health insurance coverage to low-income Pennsylvanians while, at the same time, addressing historical, systemic barriers to public health insurance access.  To that end, we focus our comments on how a Pennsylvaniarun-Exchange would be able to function best in concert with Medicaid and other public health insurance programs.[i]

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Pennsylvania legislature should work for real solutions to address the uninsured crisis

February 8, 2011

Every day at Community Legal Services, uninsured Philadelphians come to our office seeking assistance.  Medical debt is driving them to bankruptcy.  They’re putting off preventive health care because they lack insurance.  They’re worrying about how they can continue to afford their escalating monthly premiums.  And now, they’re wondering what to do after their adultBasic insurance ends at the end of the month.

When the Pennsylvania House Health Committee approved HB 42 yesterday on a straight party-line vote, it missed a critical opportunity to address the needs of the 1.3 million uninsured people in Pennsylvania.  We opposed this bill for a number of reasons.

HB 42 is out of step with the health care community. The American Medical Association, the American Cancer Society, and the AARP, among others, support the Affordable Care Act (ACA).  In Pennsylvania, an advisory committee consisting of all stakeholders including hospitals, doctors, insurers, businesses, and consumers recommended that Pennsylvania move forward with responsible implementation of the ACA.  Governor Corbett also has called for implementation without delay.

HB 42 would undermine Pennsylvanians’ obligation to take personal responsibility for their health care. The ACA requires people who can afford health insurance to have insurance.  This requirement makes sure that people do not “game the system” by waiting until they get sick to buy insurance, driving up health care costs for everyone.

HB 42 would deprive hundreds of thousands of Pennsylvanians of health insurance.  1.3 million Pennsylvanians are uninsured and more than half of a million people are on the waiting list for adultBasic.  Failure to implement the ACA would prevent these individuals from accessing affordable health insurance in 2014.

HB 42 is unconstitutional. The Pennsylvania Legislature does not have the authority to direct the Governor or state officials not to follow federal law.  Pennsylvania should permit existing litigation to work its way through the federal courts.

Even lawmakers and advocates who disagree with the ACA recognize the need for careful planning and sound implementation.  State officials will be required to make thousands of decisions about how to adapt the ACA for Pennsylvania.  Even outspoken opponents like Governor Corbett recognize the need for continued implementation as long as the ACA is in effect, to keep Pennsylvania moving forward.

We urge our legislators to come together to find real solutions to help the 1.3 million Pennsylvanians without health insurance.


Save adultBasic

May 11, 2010

Last week the House Insurance Committee held a hearing on the future of adultBasic. Adult Basic is a popular program that currently provides bare bones insurance to 40,000 Pennsylvanians who do not qualify for any other form of public or private insurance. It is so popular and fulfills such a great need that it has a waiting list of more than 390,000 people — 27% of all the uninsured in Pennsylvania.

Unfortunately, the program is threatened because its funding mechanism is up for renewal. Up to now, it has been funded by a combination of public and private funds.  Both sources are threatened. The public source is the Pennsylvania share of the Tobacco Settlement Fund, which has dwindled over the last 5 years due to competing demands for funding.  More crucial, however, is the expiration of the Community Health Reinvestment Agreement.  The CHRA is an agreement between the state and the four Blue Cross organizations in Pennsylvania.    After considerable criticism by CLS and many others of what we contended was an excess Blue Cross surplus, the Blues promised the state they would contribute 60% of their community benefit funds to funding adult Basic.  That agreement runs out December 31, 2010, leaving adult Basic on life support.  Representative Todd Eachus has introduced House Bill 2455 to preserve the program and assessing the not for profit Blues 2.4% of their premiums, about what they would pay if they were a for profit company.  CLS testified  in favor of the bill, as did Sharon Ward of the Pennsylvania Budget and Policy Center.  The Blues vigorously opposed it.

Time will tell if the popular program survives.  It would be tragic if this last ray of hope was extinguished for the 1.4 million Pennsylvanians without insurance, especially since we only need to bridge the 3 years untill federal health reform is implemented.