Free Clinic Association of PA Annual Conference

What’s Happening in Harrisburg—Budget, MA Expansion, SB 5

May 3, 2013

Harrisburg, PA

Contact Information

Anne Hart

20 North Market Square, Suite 800

Harrisburg, PA 17101

717-214-2200

hart@thebravogroup.com

Healthcare Reform in PA

What’s Been Done

• PA Fair Care – ACA Based Plan for Uninsured with Pre-

Existing Conditions– Premise was Bridge to 2014– About 6,845 enrollees (estimated 7,500

enrollees)– PPO - $283 a month– CMS suspended all new enrollment

What’s Been Done

• ACA Provides for limited HHS review of individual and small group market segments (Act 134 amends Title 40)

• Coverage and Policy Changes– Annual and lifetime limit prohibition– Dependency Age 26

What’s in the Works

• PA E-Health Partnership Authority– Created through legislation approved in July

2012. – The purpose of PEPA is to enable the secure

exchange of health information– PA awarded 17.1 million under ARRA to

establish a health information exchange.– Currently working with stakeholders– http://paehealthcollab.com/index.html

What’s In the Works

• Insurance Exchange– PA has deferred to the feds to establish an

exchange (marketplace)

MA Expansion

• Governor Corbett has not said “no,” but funding not included in proposed budget.

• Corbett met with CMS officials– CMS will consider PA a non-expansion state so that

the state would receive 100% reimbursement for the first three years

– Governor wants more flexibility for the newly eligibles– Specifically, co-pays, deductibles, work requirements

MA Expansion (Con’t)

• Reports supporting expansion: Rand (HAP), PA Economy League (PA Health Funders Collaborative), PA IFO

• Rely on Gross Receipts Tax (GRT) to make numbers work

• Feds to issue national guidance on revenue enhancements (assessments/GRT)

SB 5• Creates Community Based Health Care Program

• Hospital clinics administered thru DPW

• Grants require a 25% matching commitment.

• No more that 15% awarded to one city, town, township in PA, and FQHCs limited to 25%

• DoH to distribute funding as follows:– Up to 50% for expansion of existing clinic or new clinic– Up to 25% for improvements in prenatal, OB and newborn care– Up to 20% for improved services to reduce unnecessary

emergency room utilization– Up to 5% for collaborative relationships among providers

How to Speak to Legislators

“When you need a friend,

it’s too late”

~ Mark Twain

“Politicians work just as hard at

survival as any business.”

~ Chris Bravacos

Lobbying Legislators

Know thy legislator

• Biography (look at their website)

• Voting record on topics

• Mutual friends

• Visit in office in district

• Attend local fundraisers

Know Thyself

• You are a constituent

• You are a taxpayer

• You are a voter

• Your are an employer

• You are a caregiver

Be Clear About Your Request

• Assume legislators/staff know little or nothing about free clinics—don’t be jargony and use simple language

• Your job is to inform, educate and ASK

• Their job is to REPRESENT

Explain issue in terms they can understand

• Why is it their interest to support our position?

• Idea is popular

• It fulfills a campaign pledge—health care reform

• They can make their mark with this issue

Always tell the truth

Two responses to a question…

• The answer.

• I’ll find out.

Listen close to answer

“Yes” sounds like:“I agree, and will support that.”

“No” sounds like:“I’m with you but hope it doesn’t come up for a vote.”“I don’t want the committee to consider this legislation.”“You make some good points.”“I don’t see you enough…at my fundraisers.”“Send me more information.”“Your son/daughter was great in that game yesterday.”“I do not support…but might not oppose.”

Thank You