A city legal organization is supporting a class action lawsuit that alleges outgoing Gov. Tom Corbett’s reformed health care plan will cut off services to more than 200,000 low–income and otherwise at–risk Pennsylvanians in 2015.
The lawsuit is seeking an injunction before the cuts take effect Thursday. It was filed by Community Legal Services (CLS) in Philadelphia earlier this month
“The Constitution does not allow a government agency to make decisions about Pennsylvanians’ lives and health while keeping them in the dark about the bases for those decisions,” said Louise Hayes, CLS supervising attorney.
CLS lawyers said each of the three benefits packages provided by Healthy PA will include some benefits cuts. They also claim the plans include cuts in medical supplies. Lawyers also claim recipients the state designates as having less significant health needs will be assigned to either the Healthy or Healthy PA Private Coverage Option benefits package, which contain very significant, “potentially health–altering” cuts.
Corbett proposed the Healthy PA plan in 2013, and in 2014 received a waiver from the federal government to use a portion of the funds earmarked for the expansion of Medicaid in accordance with ObamaCare to fund the Pennsylvania plan.
“Healthy Pennsylvania is Gov. Tom Corbett’s plan to ensure that Pennsylvanians have increased access to quality, affordable health care,” the administration said. “The Healthy Pennsylvania plan focuses on three key priorities: improving access, ensuring quality and providing affordability. It is built upon common sense reforms that provide coverage options to this commonwealth’s most vulnerable citizens in a flexible and sustainable way that protects taxpayers.”
While the Corbett administration said the state will realize significant cost savings for taxpayers that can be reinvested while providing an important safety net for those individuals who need it most, the lawsuit contends the implementation of Healthy PA will cause great dismay.
The lawsuit alleges the Pennsylvania Department of Human Services is assigning 1.1 million adult Medicaid recipients to benefits packages that do not meet their needs using secret standards and without proper notice. It also contends individuals with temporary disabilities, survivors of domestic violence and individuals in substance abuse treatment are being assigned to the Healthy PA private coverage option package, which eliminates dental coverage, access to the medical assistance transportation program and some other services.
“Pennsylvania is out of step with the rest of the country,” said National Health Law Program legal director Jane Perkins. “It is implementing strict benefits cuts using unlawful secret standards at a time when many states are expanding access to health coverage.”
To illuminate the issue, the law center provided details of a case involving Aminata Diao, a plaintiff in the lawsuit.
Diao suffers from significant physical and mental health conditions, including depression, asthma and lumbago, and was assigned to the Healthy benefits package, but did not understand from the first notice her benefits were being cut and she should complete a screening questionnaire.
Diao’s second notice provided her with less than the ten days required by state and federal law to appeal and keep benefits pending a hearing.
Another plaintiff is Melissa Mendez, who suffered a fall earlier this year which resulted in extensive dental and facial reconstruction. Mendez applied for medical assistance in November, but was not given the option of qualifying for Healthy PA.
The law center said Mendez was assigned to the Healthy PA private coverage option package, causing Mendez to lose dental coverage Jan.1.
“In light of the errors caused by the Department of Human Services’ [DHS] labyrinthine and opaque processes we hope that DHS will agree not to transfer these very vulnerable Pennsylvanians to the Healthy PA private coverage option on Jan. 1,” said Kristen Dama CLS Staff attorney.