Articles of Interest

Capitolwire: Gov. Wolf signs into law bill allowing Pennsylvania to operate its own health insurance exchange, create reinsurance program.

By Alyssa Biederman
PLCA Intern

HARRISBURG (July 2) – Legislation hoping to make health insurance more accessible and less expensive for Pennsylvanians was signed into law on Tuesday by Gov. Tom Wolf.

“This bill is a huge step toward making health insurance affordable and effective for all Pennsylvanians,” said Wolf, indicating the hope is for the new law to make it so “everyone pays less.”

House Bill 3 was a bi-partisan effort to allow Pennsylvania to create its own state-run health insurance exchange, which will minimize Federal costs and allow the state to subsidize premiums.

HB3 prime sponsor and House Majority Leader Bryan Cutler, R-Lancaster, said healthcare is an issue for everyone, regardless of political party, that has to be solved.

“For too long people have been frustrated with healthcare,” Cutler, a former X-Ray technician, said. “Instead of focusing on making things better, we too often focus on what things cost.”

He added that the enactment of this bill — which will be effective for the Fall 2020 open enrollment and insurance coverage that begins Jan. 1, 2021 — will “significantly” decrease costs for Pennsylvania’s more than 400,000 private health insurance consumers that currently obtain their insurance from the federally-run exchange.

The bill will achieve this by transferring Pennsylvania’s existing health insurance exchange from federal to state control. Becoming state-run, Wolf said, will save money that will ultimately be used to decrease the amount health insurance consumers have to pay each month.

Pennsylvania has relied on the federal health insurance exchange since the implementation of 2010’s Affordable Care Act, also known as Obamacare. According to the Wolf administration, to cover costs, the federal government charges insurers a 3.5-percent fee on premiums paid by ACA enrollees each month, a projected $98 million for Pennsylvania insurers in 2019. This user fee is expected to be cut to 3 percent beginning in 2020, which would equate to approximately $88 million dollars from Pennsylvania insurers. Eliminating the need for insurers to pay that fee will allow for a redirection of that funding to help pay for a reinsurance program, which will allow insurers to price their products lower by limiting their exposure to very high, unpredictable medical expenses incurred by their members; the reinsurance program covers some of those expenses when they exceed a certain threshold.

Pennsylvania Insurance Commissioner Jessica Altman said she believes this change will incentivize more Pennsylvanians to apply for health insurance in the state.

Altman added that although the signing of the bill is a step forward, the state must continue to make health insurance more accessible.

“The passage of this legislation is analogous to registering for a marathon,” Altman said. “The race is still before us. We have a lot of training to do and roads to run before we reach the finish line.”

Cutler said he is confident that Pennsylvania’s four legislative caucuses will be able to keep passing legislation that will improve Pennsylvania’s health insurance landscape after seeing the collaboration that went into HB3. The bill passed unanimously in the House and Senate last week.

This plan was inspired by an executive order by President Donald Trump which provided states with more flexibility regarding the operation of their own health insurance exchanges.

“Regardless of how you feel about the status of things in Washington, D.C., we have a responsibility to govern here in Pennsylvania,” said Cutler. “That’s what this bill demonstrates better than anything else.”

Questions, please contact Jack Phillips.

(Message from Chuck Ingoglia, President and CEO, National Council for Behavioral Health)**

After much debate and political back and forth, the House and Senate today passed a short-term extension of the Certified Community Behavioral Health Clinic (CCBHC) Medicaid demonstration program.

As was announced last week, the House of Representatives overwhelmingly approved legislation to extend the original eight CCBHC demonstration states through December 2021. The legislation passed the House by a vote of 371-46. Despite tremendous bipartisan support in the House, efforts to extend the original eight states and expand CCBHCs to two new states stalled in the Senate. To provide themselves more time, House and Senate members agreed to a two-week extension, continuing the program through the 4th of July recess.

While we cannot guarantee a path forward beyond this short-term extension, we have every reason to believe that upon its return Congress will pass another continuation of the program through the end of September 2019. As we have throughout this legislative process, the National Council will keep you informed and do its very best to make you aware of opportunities for action and advocacy at every turn.

Thank you all for your outstanding efforts these last few years. Through your hard work and advocacy you have expanded access to individuals in need, transformed how these services can and should be delivered in your communities and built a strong network of allies who believe in the promise of CCBHCs and have worked with us to support their continuation.

**NOTE: OMHSAS/DHS are in the process of confirming the full extent of this announcement and its impact on PA CCBHCs moving forward.

(Source: National Council for Behavioral Health, Capitol Connector, June 20, 2019)

On Tuesday, the House voted to pass the “Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019 (HR 3253),” which would extend funding for certain Medicaid programs. Under the provision, funding for the eight-state Certified Community Behavioral Health Clinic (CCBHC) demonstration program would be extended for another two and a half years until December 21, 2021. There was overwhelming bipartisan support of HR 3253, passing with a vote of 371-46. The bill must now go to the Senate for a vote before the CCBHC demonstration program expires on June 30, 2019. Read more.

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Ted Dallas, most recently Special Advisor to Governor Wolf and former Secretary of the Department of Human Services (DHS), joined RCPA member NHS, a leading provider of community-based, nonprofit education and human services, as Chief Operating Officer (COO) on March 12.

“Having worked with former Secretary Dallas over the years, we are confident that he will make an outstanding addition to the NHS team,” said RCPA President and CEO Richard Edley. “RCPA wishes Ted much success in his new role and we look forward to working with him and NHS to continue improving services to those living with disabilities in the Commonwealth.”

See the NHS press release here.

RCPA is proud to announce that one of its own will be heading to Pittsburgh to lead one of Pennsylvania’s most respected human service providers for people with intellectual and developmental disabilities. COO and IDD Division Director Steve Suroviec will be serving as CEO of ACHIEVA, Inc. starting in January 2018. Suroviec has been with RCPA since August 2016 after serving in multiple leadership positions in state government. RCPA President and CEO Richard Edley said, “We are very sad to see Steve leave RCPA – with the extensive knowledge and expertise he brought from the Offices of Developmental Programs and Vocational Rehabilitation, Steve shepherded our members through many months of reforms proposed by state funding agencies, including major changes to Medicaid waivers, funding regulations, and rates. But it’s a feather in RCPA’s cap that Steve has been asked to lead a strong and prestigious service provider such as ACHIEVA. This is a tremendous opportunity for him; we wish Steve all the best as he enters the next chapter of his career in service to people with disabilities.” Suroviec will continue at RCPA through the end of November to assist in the operations and in a transition. Read ACHIEVA’s press release and see the announcement in the Pittsburgh Business Times.

The Department of Human Services (DHS) recently issued the following information and resources in preparation for the roll-out of Community HealthChoices (CHC) beginning January 2018 in the Southwest zone of the state.

Coming to the Southwest Zone in January 2018

The Department of Human Services (DHS) is committed to open and frequent communication to educate and inform individuals who will move to Community HealthChoices (CHC). It is critical that they are aware of the upcoming changes and are able to make an informed decision on their plan selection. We are using multiple channels to get the message out, and want to ensure that you are aware of upcoming information that potential participants will receive.

  • INFORMATIONAL FLYER

Participants in the Southwest Zone received this flyer (also available in Spanish) in August 2017 to inform them that CHC was coming to their county in January 2018.

  • CHC Community Meetings for Participants

Participants in the Southwest will receive an invitation to community meetings in late September.

There will be more than 40 events in the Southwest Zone, with at least one in each of the 14 impacted counties. The meetings will give more information about CHC, the LIFE program, and answer questions participants may have.

To register for a community meeting, participants can go to www.healthchoices.pa.gov or call 1-833-735-4416. A copy of the invitation is available here.

  • Notices

DHS will mail notices to potential participants beginning today. The notice will inform participants that they will transition to CHC in January and will need to select a health plan, also called a managed care organization (MCO).

The notice also tells potentially eligible participants that they may be eligible for the LIFE program.

Copies of the notices are be available here.

  • Pre-Enrollment Packets

Beginning on October 2, 2017, pre-enrollment packets will be mailed to participants. This packet will contain information about each of the health plans and the benefits offered by each plan, and tell participants how to enroll in a health plan. There will be a toll-free number and website for participants to use to make their selection. A day after the packets are mailed, automated calls will be made to let participants know that the packets are coming.

If participants do not select a health plan, they will get a follow-up call.

Individuals who do not select a plan by November 13, 2017, will be assigned to a plan. Individuals can change their plan at any time.

  • Social Media

DHS’ Facebook, Twitter, and YouTube accounts make CHC information readily available. If you are not following us yet, please click the provided links to make sure you are receiving all up-to-date information on CHC and all department priorities.

chc-phases-map

(Map, Community HealthChoices Phases)