Pennsylvania Sued Over Health Care Changes

Community Legal Services has filed a lawsuit against Pennsylvania's new health care plan, saying it contains "very significant, potentially health-altering cuts."

Earlier this week, Community Legal Services filed suit against the state of Pennsylvania over changes to health care beginning next year.

Under the changes coming next year, Pennsylvania’s Medicaid program is being renamed from HealthChoices to Healthy Pennsylvania. Instead of expanding traditional Medicaid coverage as recommended in Obama’s health care law, Pennsylvania instead decided to expand on its own — accepting only some money from Medicaid.

All Pennsylvanians in Healthy PA are being moved into three tiers of coverage. In the suit — Mendez v. Mackereth — against the state’s Department of Public Welfare, CLS argues two of the three new health care options under Healthy PA “contain very significant, potentially health-altering cuts.”

CLS explains some of the cuts in a release:

Individuals with temporary disabilities, survivors of domestic violence, and individuals in substance abuse treatment are being assigned to the Healthy PA PCO package, which eliminates dental coverage, access to the Medical Assistance Transportation Program, and some other services. The federal Centers for Medicare & Medicaid Services (CMS) approved the Healthy PA PCO benefits package on December 17, 2014, so Medical Assistance recipients assigned to the Healthy PA PCO package face cuts on January 1, 2015.

Very low-income parents and young adults transitioning out of foster care are being assigned to the Healthy benefits package, which includes strict new annual benefits limits of four specialist doctor visits, six radiology tests, and $350 in laboratory services. CMS has not approved the Healthy benefits package. DHS has indicated that it will keep Medical Assistance recipients assigned to the Healthy package in their current plans, or near equivalents, until it receives approval, so they may not face cuts until after January 1, 2015.

Recipients were notified of which plan they’d be placed into in November. “The notices sent to recipients did not identify the reason that a person was assigned to a particular package or why they were not given the package with the most benefits,” CLS says in a release. “Even more troubling, DHS has refused to make public its criteria for assignments to the benefit packages.”

Corbett’s camp struck back at the lawsuit. “The federal government is not going to approve a health screening tool that would in any way impede coverage for these individuals,” Corbett policy director Jen Branstetter told the Pittsburgh Post-Gazette. “This administration will be incredibly disappointed if one person did not get access to health care coverage on Jan. 1 because of this lawsuit.”

Tom Wolf has said he wants to dump Corbett’s plan and accept the money from the Affordable Care Act without restrictions. CLS’s suit seeks an injunction against the benefits changes.

Read a copy of the suit below.

Mendez v. Mackereth