News today that Pennsylvania is withdrawing its Healthy PA Medical Assistance (Medicaid) plan for what should be a much more comprehensive and simpler Medicaid Expansion should be welcome news for the poor in Pennsylvania. Since Healthy PA was implemented, our Legal Aid office has been receiving calls about it from clients describing ways it was cutting their health care coverage. For example, one client diagnosed with lymphoma last fall found himself categorized by the state as not needing full coverage and was put into a new private insurance plan in the midst of his treatment. Potentially, that lesser plan would not have covered his treatment and the physical and mental health problems he developed due to his diagnosis. Under the “traditional” Medicaid Expansion the state is planning to choose, he should now be covered, as will many more of our clients suffering with HIV, cancer and disabilities who will more likely be able to live independently in the community.
As a teacher in the Temple Legal Aid Office, I have the chance with my students to watch the way the poor face life and how government decisions on how to help those seeking help really matter. Although Medicaid Expansion is a start and will have a heavy impact on our clients, other governmental decisions and a weakening economy for the poor has made poor people today look very different than they did a few years ago. Welfare paid to parents with children who cannot support themselves (TANF) has not increased in Pennsylvania since 1990 and leaves a family of three below 25% of the federal poverty line in deep poverty. Since 2012, welfare is not paid in the state to people with illnesses disabilities who have not yet proven their eligibility for the federal SSI program or whose disabilities last less than a year—this has affected many of our clients with severe acute disabilities, like people going through cancer treatment that devastates them like chemotherapy but whose disabilities are considered short term and not worth help. We see the effects of this lack of minimal amounts of welfare in little things, like clients who can no longer afford phones and rely on phones with limited minutes so they cannot seek work easily or stay in contact with people who can help them with their problems, like their legal aid lawyers and our interns, or people who used to be able to contribute at least something household expenses who no longer can.
Medicaid Expansion will help many. They will find it a great start toward getting help they need, but maybe only a start.