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House of Representatives
Session of 2019 - 2020 Regular Session


Posted: October 28, 2019 08:42 AM
From: Representative Dan Frankel
To: All House members
Subject: Medicaid Buy-In
Health care costs are causing Pennsylvanians economic hardship, with 1 in 3 Pennsylvanians struggling to pay for health care now, and 4 out of 5 Pennsylvanians worried that they’re going to have trouble paying for health care in the future, according to a study funded by the Robert Wood Johnson Foundation.

They’re worried about the cost of drugs and the cost of insurance. They think pharmaceutical companies and hospitals alike charge too much. And 78 percent agreed “The system has to change.”

We know that for individuals who don’t have health insurance subsidies, a plan in the private market can cost up to a fifth of their yearly income – and that’s even for plans that cost consumers more in co-insurance, co-pays and deductibles when they need to use their insurance.

Even people with health insurance through their employer are paying on average $6,000 a year in health care, out of the more than $20,000 these plans cost annually, according to the Kaiser Family Foundation. This puts health care out of reach for people who have access to employer-sponsored coverage.

The “Affordable Access for Pennsylvanians” bill will direct the Department of Insurance and the Department of Human Services, in collaboration with the State Based Exchange, to develop a proposal for Pennsylvania residents to buy into Medicaid plans in order to provide an affordable option for Pennsylvanians struggling to purchase health insurance and a path toward a system that treats health care as a right, not a privilege.
Medicaid is an efficient program. In Pennsylvania, private providers actually manage almost all of our Medicaid programs already, and compete aggressively for that opportunity.

The quality of care is high, with studies showing that access to health insurance coverage under Medicaid leads to a wide range of health improvements from better mental health to reduced mortality.

And costs are lower than private insurance – one study of Medicaid plans found that it would cost 25 percent more to cover an adult through the commercial insurance market.

The Commonwealth uses its leverage as a purchaser to get high-quality, lower-cost care, in order to serve patients and taxpayers. We should use the Commonwealth’s negotiating strength on behalf of consumers. We should let people buy in to the Medicaid program, which manages to hold costs down and keep quality high.