Folks here’s a story about Minnie the Moocher of Pennsylvania. According to the state’s governor, she’s a health care moocher and is either pregnant or a breast cancer patient. It wasn’t enough for the Republicans of the state to decide against expanding Medicaid under the Affordable Care Act, citing that it would cost the state too much, but Gov. Tom Corbett (R) took it one step further. During an interview with a local news station, Corbett said that poor residents who are already enrolled in the program, including pregnant women and breast cancer patients, are receiving too much free care and should pay into the system.
Poor and pay? Some how those two words don’t seem to go hand in hand.
“What I hear all the time coming out of the administration in Washington is that it’s the working poor [who benefit from Medicaid],” Corbett told WTAE, a local ABC affiliate, on Saturday. “Yes it is working, but you should be investing five, ten dollars in co-pay to understand that you go to to the hospital or the doctors, you just can’t keep going and going and going and think everything is going to be covered. You have to know that you have some interest in what’s going on.”
This statement touched home for me because a recently unemployed friend in the “City of Brotherly Love” was recently diagnosed with breast cancer at the age of 33. With her Cobra payments almost $900 a month, she couldn’t afford to tack on an extra expense. Just a month into being unemployed, she detected a lump. After she was laid off, she really didn’t feel the need to worry about having health insurance, since she prided herself on “never getting sick”. Needless to say, being unemployed and having breast cancer left her with no other option but to apply for Medicaid while she continued her job search.
It should be noted that there is already a copayment system in place for those on Medicaid in Pennsylvania.
According to the state’s website no copayments are required for:
- Persons younger than 18 years old. This is any person who has not reached his or her 18th birthday.
- Pregnant women (including post-partum period)
- Residents of a long term care facility or other medical institution.
- Individuals receiving hospice care.
- Women in the Breast and Cervical Cancer Prevention and Treatment (BCCPT) Program.
- Individuals in the Title IV-B Foster Care and IV-E Foster Care and Adoption Assistance Programs, regardless of age.
- Any services during an emergency situation. An emergency exists when immediate medical care is necessary to prevent death or serious damage to health. If the doctor, hospital or other medical provider does not agree that the situation is a true emergency, you will be responsible to pay the copayment for the service.
- Laboratory services
- If you get an x-ray or certain other medical diagnostic tests, or have treatment through nuclear medicine or radiation therapy, there will be no copayment on the physician’s part of that service. (A special physician has to “read” the x-ray or test.) However, there is a copayment on the “technical” part of the service which is the actual x-ray or test.
- Family planning services and supplies
- Home health agency services
- Services provided to individuals receiving hospice care.
- Psychiatric partial hospitalization program services
- Funeral Director services
- Renal dialysis services
- Blood and blood products
- Ostomy supplies
- Rental of durable medical equipment
- Targeted case management service.
- Tobacco cessation counseling services
- Services for which the Medical Assistance fee is less than $2
- Medical examinations which are requested by the Department of Public Welfare to determine public assistance eligibility, employability, mental competency or need for skilled nursing or intermediate care facility services.
- Medical examinations for persons under age 21 provided through the Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT).
- More than one of a series of specific allergy tests provided in a 24-hour period.
Currently the state’s copayments are fairly reasonable, and definitely cheaper than my friend’s $900 a month Cobra fees:
- $3 for each day you are in a hospital, up to $21 for one hospital stay. This includes general hospitals, rehabilitation hospitals or private psychiatric hospitals.
- $1 for each prescription and prescription refill of a generic drug.
- $3 for each prescription and prescription refill of a brand name drug.
- $1 for each x-ray or other medical diagnostic test or for treatment by nuclear medicine or radiation therapy.
- For outpatient psychotherapy services, the copayment is $.50 per unit of service.
It would be interesting to know what the governor thinks these copays should be increased to, because according to him, all mooching should come to an end.