How a Small Provision of ACA Made a Big Difference for One Pennsylvania Family

Years after its passage, I am still finding new ways that the ACA helps my family.

For over two and a half years, my family has been involved in the fight to save the Affordable Care Act and prevent cuts to Medicaid. We travel around Pennsylvania and Capitol Hill educating others about the importance of maintaining these programs while sharing our story.

I thought I knew everything about the ACA, but a few weeks ago, I learned that it continues to help families as states implement and embrace every part of the law.

Our home state of Pennsylvania has a Medicaid provision known as PH 95, which qualifies disabled children for Medicaid regardless of parental income. My sons, Jackson and Henry, are disabled and have had Medicaid under this provision since 2012. PH 95 has existed since the 1980s, and currently provides coverage, supports, and services to over 60,000 disabled children in Pennsylvania. It has been a lifeline for our family.

A few weeks ago, I sat down to fill out the tedious Medicaid renewal application. It is always really stressful. Prior to having Medicaid, we tried to pay for our sons’ care out of our own pockets and it nearly bankrupted us. Every year, as we fill out the renewal, we are consumed with fear. We know that any error, a missed deadline, or an incomplete application could lead to loss of coverage. Losing Medicaid for our sons would not only mean financial ruin, but would also severely impact Jackson and Henry’s quality of life and limit their access to care.

My fears were confirmed when the website would not let me choose the option to renew their benefits.

In a panic, I visited our profile and under my sons’ names read: “Medicaid renewal date: June 30, 2020.”

I had not applied for renewal yet, so I was confused. How was it possible that Jackson and Henry had been approved for another year before receiving our application?

I assumed it was a mistake that would lead to a lapse in coverage, so I called the PA Medicaid helpline the next morning. A representative confirmed that the boys’ Medical Assistance had been automatically renewed through an ex parte renewal.

That is when I learned that under the ACA, states are required to streamline Medicaid enrollment by renewing coverage no less than every 12 months using an electronic process that promotes retention. Ex parte renewals use third party data services to confirm ongoing eligibility.

It makes perfect sense. My sons’ childhood disability status will not change. Under the PH 95 waiver, income isn’t counted, so an income change would not matter, either. Automatic renewals save Medicaid recipients from lapsing in coverage due to missed deadlines. Low income individuals, disabled persons, and parents of disabled children already have so much on our plates. Knowing there is one less thing to worry about is such a relief. In addition, ex parte renewals benefit those who do not have the economic resources needed to apply online.

I am so grateful for my state’s willingness to lend support to those who need it most. While other states are implementing work requirements and other policies to kick people off of Medicaid, Pennsylvania is streamlining the process to keep people on it.

We appreciate that Governor Tom Wolf and Pennsylvania’s Department of Human Services continue to work so hard to protect the most vulnerable in our state. My heart goes out to the residents of states where all aspects of the ACA have not been implemented.

The provisions of the Affordable Care Act benefit all of us – not only those who receive insurance through the Marketplace or who have benefited from Medicaid expansion. Americans covered by traditional Medicaid and those who have private insurance are protected by the ACA, as well. Attempts to repeal the law through legislation and judicial actions will harm people all across the country.

For many, the protections given to us and the people we love under the ACA has provided much relief and security. We cannot surrender that refuge so easily. We must do everything in our power to fight against every threat of repeal. Our lives and our livelihoods depend on it.

Please read more about ex parte Medicaid renewals here.

By: Anna Kruk Corbin, mom to Jackson (13) and Henry (11)