OUR PRIORITIES

ENHANCING COVERAGE

ENHANCING COVERAGE

People deserve comprehensive, high quality, affordable coverage.

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INCREASING ACCESS

INCREASING
ACCESS

All people should have equal access to healthcare with a choice of providers.

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IMPROVING OUTCOMES

IMPROVING OUTCOMES

People need the right care and supports to make them healthy.

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HEALTHIER COMMUNITIES

HEALTHIER COMMUNITIES

We are committed to reducing health disparities and improving the health of whole communities.

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Cover All Kids

At PHAN, we believe that access to health care should not depend on what family you were born into. But 24,000 children in Pennsylvania go without necessary pediatric check-ups, dental exams, and medications they need to stay healthy. Because they are undocumented, these children are denied access to our state Children’s Health Insurance Program (CHIP).

The Dream Care Campaign is working to change 13 words in state law so that all Pennsylvania’s children, regardless of their immigration status, can receive quality health care.

Pennsylvania can provide CHIP coverage to these children – who make up less than 1% of all children in PA.– for approximately $15.4 million, less then 1/20th of 1% of the state budget. And over the last year, the federal government has provided more financial support for CHIP program costs, which means that Pennsylvania’s state costs have been reduced by $90 million. Providing health insurance for undocumented children saves money in the long run, too: The amount of money it takes to insure a child through CHIP is half the amount hospitals and the state currently cover in uncompensated care costs for each child.

Five states have already made undocumented children eligible for CHIP or Medicaid, and seven out of ten Americans believe undocumented children have a right to the same benefits as refugees: Medicaid or CHIP eligibility.

PHAN is part of the 40-member Dream Care Coalition, led by Public Citizens for Children and Youth. Click here to sign on to the Dream Care Campaign and work to fulfill Pennsylvania’s promise to cover all kids!

Network Adequacy

When consumers enroll in a health insurance plan, they gain access to a network of medical providers. Insurance companies contract with a range of providers, including both primary care and specialty physicians, to deliver health care services included within the plan’s benefit package. This network of providers must be adequate to ensure that consumers enrolled in the plan have reasonable access to all covered benefits. This is what is meant by network adequacy.

As narrow provider networks become more common, health care consumers need accurate and more usable information about the size and composition of provider networks to make meaningful choices about health insurance.

Parity

Parity means that individuals have equal access to physical health and mental health/substance use services and treatments through their health plans. Insurance companies cannot place limitations or additional financial requirements on mental health/substance use services and treatments that don’t exist for physical health services and treatments.

In 2008, President Bush signed the Parity Act into law, which requires insurance companies to provide for mental health/substance use conditions equally to physical health conditions. However, it is up to each individual state to make sure insurance companies are following this law.

Parity violations occur when insurance companies do not provide mental health or substance use benefits equal to physical health benefits. Some examples include:

  • Higher copays for mental health/substance use providers
  • Separate deductibles for mental health/substance use treatments
  • Limits on the number of times a consumer can visit a provider
  • Limits on the number of days a consumer can stay in a treatment facility
  • Higher prices for prescription medicines
  • Frequent insurance approval required to continue services
  • Denial of prescribed residential treatment
  • Denial of prescribed treatment in lieu of less expensive treatment

Pennsylvanians deserve better!

In order to enforce the federal Parity Act, Representative Tom Murt (R – 152nd Legislative District) recently introduced parity implementation legislation, House Bill 2173. This legislation will improve the lives of our family and friends by giving them access to the health services they need, enhance the state’s authority to monitor and enforce parity, and educate consumers about their rights. This bill does not create any new requirements for insurance companies, it simply holds them accountable for following the 2008 federal law.

PHAN supports HB 2173  and is committed to educating consumers about their rights. Contact us if you or someone you care about is having problems accessing mental health/substance use services and you think it might be a parity violation. We want to hear from you!