The Utah Department of Health is proposing significant changes to Utah’s Medicaid and PCN program. Every comment will make a difference. See below for a sample comment template and talking points. Comments are due to the federal government by September 30th. You can submit comments here.
Waiver Comment Template:
The proposed revisions to Utah’s initial waiver application (Submitted to CMS August 18, 2016) would increase the number of uninsured Utahns, keep many in a cycle of poverty, and make our state less healthy. The proposed amendments to Utah’s 1115 waiver application would create more barriers to care.
I object to these proposed revisions to the original 1115 waiver application, including time limits, work requirements and higher co-pays, because they will undermine the health of Utahns including the chronically homeless, people in need of substance use or mental health treatment, people with chronic conditions and low-income parents.
I support the goal of encouraging people to be self-sufficient and return to work. But there are more effective ways to accomplish these goals, without undermining Utahns’ health. Greater time should be given to studying the impact of these proposed changes on Utahns’ everyday care, before moving forward with increased restrictions.
More importantly, with thousands of Utahns still without health coverage, the Governor and Department of Health should first ensure all Utahns can access comprehensive, affordable care, before increasing penalties and limits on their care.
Sample talking points for different populations:
Chronically homeless, substance use and mental health treatment: The proposed restrictions on enrollment for adults without children will hurt this transient population. If people in this category lose their coverage, they will likely be unable to re-enroll. This will create disruptive gaps in their coverage and care. Consequently, these highly vulnerable enrollees will find it extremely difficult to maintain access to critical treatment and recovery services.
Domestic violence and trauma: If parents or individuals lose their coverage due to time limits or work requirements, it creates an added financial and emotional strain on these already vulnerable families or individuals. Moreover, individuals will experience disruptions in care and may be unable to stabilize a mental or physical health condition, which could put them at an even greater risk for domestic violence, ACES and trauma.
Parents and children: If parents lose their coverage due to time limits or incomplete work requirements, we will see an impact on children as well. When parents have health insurance coverage, children are more likely to have coverage. The converse is also true; when parents do not have coverage, there are lower rates of insured children.
Chronic physical or behavioral health conditions (e.g. depression, diabetes or asthma): Many people on the PCN program rely on the care it affords to manage chronic conditions, but do not qualify for disability Medicaid. As a result, time limits on PCN may be particularly harmful to this group, who may be otherwise unable to continue working. People may not know they are exempt, or maybe have difficulty navigating the exemption process.
Working individuals and families: The vast majority of Medicaid enrollees live in households where at least one member is working. Also, nationally over half of non-elderly, non-disabled Medicaid enrollees are already working themselves. While the majority work full-time, most have low-wage jobs that don’t offer affordable coverage options. At the same time, for any number of reasons, almost 1 in 5 are only working part time. An additional 30-hour-a-week job search/work requirement will be especially challenging for these individuals and hit families with older children particularly hard.
Parents and caretakers using the ER: A $25 co-pay for incorrect use of the ER will likely only lead to delayed, and ultimately more costly, care for parents and caretakers. Moreover, parents may also be less likely to take their child to the ER. This is an especially shortsighted suggestion when the state has yet to adequately invest in preventive and non-ER alternatives to off-hours care. Research shows that additional fees are not effective means to reduce ED use.