In the passage of The American Health Care Act, people with disabilities will again be on the losing end of access to health and mental health care. Medicaid as it has existed since it was created will no longer exist to ensure critical access to supports and services to allow individuals with disabilities to remain vital and active in their communities. The decision to allow states to either Block Grant or create a Per-Capita payment will result in the program being eligibility based instead of an entitlement. Individuals will only get services if funding is available, and if there is not enough funding then individuals will be placed on a waiting list. Waiting lists for services will grow exponentially and individuals with disabilities could be placed in life threatening situations.
The AHCA removes the requirements to provide “essential health benefits” and coverage for pre-existing conditions to gain more votes for passage. Removal of essential health benefits, effectively obliterates out-of-pocket caps, and reinstates annual and lifetime limits. Insurers can once again put a cap on how much care a person with a disability receives but not on how much people owe. Individuals with employer-sponsored coverage are at risk too because states can determine what, if any, essential health benefits will be required to provided by plans offered in the state.
People with disabilities who have pre-existing conditions won’t be able to find plans that cover the services they need. Without essential health benefits, pre-existing condition protections in Pennsylvania will exist in name only. It would be difficult to find needed coverage at any price, much less an affordable one. The fact that insurers have to sell coverage is meaningless if individuals can’t find a plan that covers the treatment they need.
Individual market plans won’t cover substance use treatment, mental health treatment, or other key services. This bill includes a lump sum payment to Pennsylvania for these services, people with disabilities have to hope that the money is used for these services and that those resources cover the demand for services. Otherwise, individuals will be left to cover the cost of services on their own.
The Senate should either reject the AHCA or replace this bill with legislation that supports the needs of people with disabilities and retains the current Medicaid financing system.
For more information about the rights of people with disabilities visit Disability Rights Pennsylvania website by clicking here.