PA Halts Plan To Charge Families of Disabled for Services
Posted Oct 01 2012 12:00am
HARRISBURG, Pa. (AP) — Gov. Tom Corbett 's
administration on Friday shelved a plan to require thousands of
families to help pay for Medicaid coverage for children with autism and
other disabilities, which they now get for free.
proposed copayments for wealthier families that had provoked criticism
from parents and lawmakers were put on indefinite hold while officials
instead work to win federal approval for a new premium that would be
paid up front, Public Welfare Secretary Gary Alexander said.
department has always preferred the option of applying a premium to
this program and will be working with stakeholders who have come to us
in support of a premium as opposed to the copayment," Alexander said.
copay requirement took effect Monday for new applicants and was
scheduled to be extended on Nov. 1 to about 48,000 children who are
proposal applied to families whose incomes are at least double the
poverty level. For a family of four, that works out to about $46,000 a
year. Once the monthly copays reached 5 percent of a family's income,
the state would pick up the full tab.
parents complained that the cost of the copays was excessive and said
it was unfair to impose a new cost on one group of Medicaid recipients.
State officials had argued that it was not unreasonable to ask people
with higher incomes to pay part of the expense and that the change would
save the state about $4 million a year.
Bouder of Manheim, an advocate for children with disabilities whose
17-year-old son is autistic, said he was pleased the copayments were
said stakeholders are "not categorically opposed to the notion of
cost-sharing," but that any premiums should not be higher than what it
would cost to insure a healthy child and that any cost-sharing
initiative should result in savings to taxpayers.
"The devil's in the details," he said.
lawmakers, responding to complaints from alarmed constituents, had
called for the co-payments proposal to be delayed or stopped.
One of them, Rep. Gene DiGirolamo , chairman of the House Human Services Committee ,
questioned in a letter to Alexander last week whether the department
had the authority to impose the copay requirement before such
regulations were approved.
Bucks County Republican said Friday he believes a premium imposed on
wealthier families is "something that's a whole lot more reasonable"
than a copayment that is left up to service providers to calculate
overall program that covers children with autism or any of several
other mental and physical disabilities costs state and federal taxpayers
about $700 million a year, said Department of Public Welfare spokeswoman Anne Bale .
80 percent of the children enrolled in the program are from families
whose incomes exceed 200 percent of the poverty level, and about
one-quarter of the children come from families who make more than
$100,000 a year.
Carrie Van Buskirk
of East Petersburg, who helped organize a Lancaster County group of
mothers of autistic children, said state officials should step up
enforcement of a 2008 law that requires many private insurers to provide
up to $36,000 a year in coverage for autism diagnosis and treatment for
patients under 21.
Buskirk, who has two young autistic sons, said she considers a copay or
a premium targeting disabled children "a disability tax."
She applauded Alexander's promise to work with stakeholders.
"We feel that we've achieved a seat at the table, which is all we ever wanted," she said.