SNAP Asks PA Congressional Delegation to Support Medicaid DSH Cut Delay (Letter)
SNAP asks members of Pennsylvania’s congressional delegation to advocate a two-year delay of Medicaid DSH cuts during upcoming federal budget deliberations.
SNAP Thanks PA Delegation for Supporting Short-Term Medicaid DSH Cut Delay
SNAP has written to members of Pennsylvania’s congressional delegation to thank them for voting for a temporary delay of Medicaid disproportionate share (Medicaid DSH) cuts mandated by the Affordable Care Act.
The Medicaid DSH delay was included in a continuing resolution that Congress passed to fund the federal government temporarily while legislators continue to negotiate an FY 2020 federal budget. The continuing resolution and the Medicaid DSH cut delay run through November 21.
Medicaid DSH cuts mandated by the Affordable Care Act have already been delayed several times by Congress, but if not delayed again, Pennsylvania will see its federal Medicaid DSH allotment fall 40 percent in FY 2020 and 80 percent a year from FY 2021 through FY 2025.
See SNAP’s thank you note to Pennsylvania’s congressional delegation here.
SNAP Thanks PA Delegation for Supporting Temporary Delay of Medicaid DSH Cuts (Letter)
SNAP thanks members of Pennsylvania’s congressional delegation for voting to include a temporary delay of Medicaid DSH cuts in the continuing resolution that funds the federal government through November 21.
ACA May be Improving, Saving Lives
The insurance expansion made possible by the Affordable Care Act may be improving and even saving lives, some studies and anecdotal evidence suggest.
While observers warn that it is difficult to attempt to render a final verdict on the reform law’s insurance expansion and its impact, various studies and observations point to encouraging developments. Among them:
- High blood pressure is being detected at a higher rate now among people who bought insurance as a result of the ACA than it was prior to the law’s passage.
- Fewer 19-26 year-olds, now permitted to remain on their parents’ health insurance, are choosing not to see a doctor about their asthma because of the cost of seeking care.
- Women in Michigan report having an easier time obtaining birth control pills.
- Participants in a Michigan program are reporting an increased likelihood of learning they have chronic medical conditions than was the case before they were insured.
- People between their mid-50s and mid-60s living in states that expanded their Medicaid programs, and who took advantage of that expansion, had a lower death rate than similar people in non-expansion states.
Pennsylvania is among the 37 states (including the District of Columbia) that took advantage of the Affordable Care Act to expand its Medicaid program.
Learn more about some of the documented and observed benefits of the Affordable Care Act’s improved access to health insurance in the Washington Post article “With the Affordable Care Act’s future in doubt, evidence grows that it saves lives.”
CMS Adopts Methodology for Medicaid DSH Cuts
Medicaid DSH money will be allocated among states based on a new methodology under a regulation adopted this week by the Centers for Medicare & Medicaid Services.
But it is not clear when that new methodology may actually be used.
Cuts in Medicaid disproportionate share hospital (Medicaid DSH) allotments to states were mandated by the Affordable Care Act based on the expectation that the law would greatly reduced the number of uninsured Americans. While this has been the case, the decline in the number of uninsured has not been as great as expected. For this reason, Congress has on several occasions delayed the required Medicaid DSH cut.
That cut is now scheduled to take effect next week, on October 1, but a continuing resolution to fund the federal government, passed last week by the House and now under consideration by the Senate, would delay that cut again – at least until November 22.
Should the cut be implemented, Pennsylvania would lose 40 percent of its Medicaid DSH allotment from the federal government in FY alone and that cut would rise to 80 percent a year from FY 2021 through FY 2025. Pennsylvania safety-net hospitals view Medicaid DSH as an important part of their effort to care for the uninsured and underinsured residents of the low-income communities in which they are located.
Learn more about the new regulation governing the future allotments of Medicaid DSH money to the states and the prospects for Medicaid DSH allocation cuts being made anytime soon in the Healthcare Dive article “CMS finalizes Medicaid DSH cuts, but Congress could still delay” and see the regulation itself here.
SNAP Takes Position on State Medicaid Funding After Hahnemann Closure
Pennsylvania’s Medicaid resources should follow now-closed Hahnemann University Hospital’s Medicaid patients as those patients turn to new providers, the Safety-Net Association of Pennsylvania declared in a position statement issued this week.
According to SNAP,
…the best way to protect access to care and prevent additional financial strain on Philadelphia hospitals is to ensure that all state resources reallocated in the wake of Hahnemann University Hospital’s closure follow the displaced patients.
In preparation for addressing this challenge, SNAP performed a data-based analysis of where Medicaid patients turned for care upon the closing of St. Joseph’s Hospital, like Hahnemann a high-volume Medicaid provider and located in the same community as Hahnemann, in 2016. This analysis identified where patients went when St. Joseph’s closed and in its position statement, SNAP urges state policy-makers to perform similar analyses and ensure that state Medicaid resources, especially supplemental payments made to hospitals that serve especially large numbers of Medicaid patients, be distributed to the hospitals that actually serve displaced Hahnemann patients. Such an approach, SNAP maintains, is the best way to ensure the future of the health care safety net in Philadelphia.
Learn more in the SNAP position statement “Protecting Philadelphia’s Health Care Safety Net From the Financial Implications of the Closing of Hahnemann University Hospital.”
PA Senate to Take Up Medicaid Work Requirement
Undeterred by past defeats, members of PA’s state senate are again attempting to advance Medicaid work requirement legislation.
This time, the proposal to impose a Medicaid work requirement will add new flexibility to such a requirement, offering exemptions for individuals deemed “medically frail” and enabling individuals who do volunteer work, attend college, or who are actively looking for work to continue qualifying for Medicaid benefits.
The proposal will be considered by the Senate Health and Human Services Committee.
The legislature has passed two Medicaid work requirement bills in the past but Governor Tom Wolf has vetoed them.
Learn more about this latest effort to establish a Medicaid work requirement in Pennsylvania in the PA Post article “Wolf, Republicans resume tug-of-war over Medicaid work requirements.”
Millions Eligible for Health Insurance Remain Uninsured
More than 15 million Americans who are currently entitled to free or subsidized health insurance are currently uninsured.
Among them are 11 million who are eligible for Medicaid but have not applied for benefits and 4.2 million who could afford insurance with the help of federal premium subsidies and either have decided not to take advantage of those subsidies or are unaware of the availability of such subsidies.
In addition, another two million people would be eligible for Medicaid if their states expanded their Medicaid program as authorized by the Affordable Care Act.
In light of such figures, it is not entirely surprising that the uninsured rate, according to the census bureau, rose last year for the first time since implementation of the Affordable Care Act. That uninsured rate, 15 percent at the time the law was adopted in 2010, fell to 7.9 percent in 2017 but rose to 8.5 percent in 2018. The uninsured rate has especially risen among Hispanics and the foreign born.
Another possible reason for the rise in the number of uninsured Americans: the federal government has greatly reduced its outreach effort to inform people about the various options they have for obtaining insurance.
In Pennsylvania, a state with a population of 12.8 million, the number of uninsured people increased just 700 from 2017 to 2018. 699,000 residents of the state are currently uninsured.
Learn more about who is uninsured and why the uninsured rate has risen in the Washington Post story “Millions of Americans aren’t getting health insurance, even though they’re eligible for free or affordable plans.”
SNAP Position on State Medicaid Funding After Hahnemann Closure (Position Paper)
SNAP urges state policy-makers to ensure access to care in Philadelphia by directing Medicaid resources previously received by the now-closed Hahnemann University Hospital to the providers to which displaced Hahnemann patients now turn for care.
ACA Has Reduced Insurance Disparities
The Affordable Care Act is responsible for a major reduction in the disparity of insurance status among racial and ethnic minorities.
According to a new Commonwealth Fund analysis,
All U.S. racial and ethnic groups saw comparable, proportionate declines in uninsured rates… However, because uninsured rates started off much higher among Hispanic and black non-Hispanic adults than among white non-Hispanic adults, the coverage gap between blacks and whites declined from 11.0 percentage points in 2013 to 5.3 percentage points in 2017. Likewise, the coverage gap between Hispanics and non-Hispanic whites dropped from 25.4 points to 16.6 points.
Learn more about specific differences among racial and ethnic groups, differences based on residence in Medicaid expansion states and non-expansion states, and differences in securing public or private health insurance in the Commonwealth Fund study “Did the Affordable Care Act Reduce Racial and Ethnic Disparities in Health Insurance Coverage?”