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Community Legal Services Commends the Wolf Administration for Improving Health Coverage for Kids

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Community Legal Services Commends the Wolf Administration for Improving Health Coverage for Kids

Community Legal Services (CLS) congratulates the Wolf Administration, particularly Commissioner Teresa Miller of the Pennsylvania Insurance Department, for yesterday’s announcement that the state will improve the CHIP program and benefit all the families covered by CHIP.  Pennsylvania’s decision to improve CHIP not only makes sure that the 3,600 families who purchase CHIP coverage at full cost will not be penalized for having inadequate coverage, but will also extend that improved coverage to all children covered by the program. 

This action was needed because the coverage previously offered by CHIP did not meet the federal requirements for minimum essential coverage under the Affordable Care Act.  CLS, along with other advocates for children’s health, had encouraged the Commonwealth to work with CHIP insurers to make sure all coverage meets federal standards this year, and yesterday’s announcement accomplishes that goal. CHIP has proven to be a successful program in helping to keep kids healthy and these changes will build on an already high quality program for insuring kids.

Richard Weishaupt, a Senior Attorney at Community Legal Services, said, “The actions of the Wolf Administration continue Pennsylvania’s role as a national leader in providing high quality health care to all children.  By not only extending benefits to families who purchase CHIP coverage at full cost, but also improving the program for all 148,000 kids covered by CHIP, Pennsylvania has done the right thing.  This is a good thing for all Pennsylvania kids and great news to their families.”

Among the added benefits that will become available in all CHIP plans are a prohibition on annual and lifetime dollar limitations for specific services classified as essential health benefits, including durable medical equipment, hearing aids, pediatric vision and dental service, including orthodontic services. Prior to the minimum essential coverage requirements, there were limits including $1,500 per year for dental and orthodontic care, $5,000 per year for durable medical equipment, and $120 per year for glasses.

In addition, many preventive care services must now be provided without cost sharing, such as co-payments, coinsurance, or deductibles. Among these services are plaque control programs, oral hygiene education, dietary instruction, and prescribed iron supplementation. And, finally, health plans will be required to provide parity between mental health/substance abuse benefits and medical/surgical benefits.