Discord over whether Pa. kids would get better care in Medicaid or CHIP

One goal of the Affordable Care Act is to get more kids insured through Medicaid, but Gov. Tom Corbett fears that shift could spell the end for Pennsylvania’s longstanding Children’s Health Insurance Program, or CHIP.

Corbett is asking the feds to exempt Pennsylvania from the change.

CHIP now operates in states across the nation, but it began in Pennsylvania under then-Gov. Bob Casey Sr.

Last week, Corbett extolled the benefits of CHIP and said the federal health law might shift to Medicaid more than three-quarters of the kids now in the program, threatening the future of the state program.

This week, Obamacare supporters roared back with support for Medicaid.

Colleen McCauley, health policy director for the nonprofit group Public Citizens for Children and Youth, says Medicaid — which is called Medical Assistance in Pennsylvania — gives children “richer” benefits than CHIP.

As example, McCauley said CHIP vision care in Pennsylvania provides only one pair of glasses to a child each year.

“Six-year-olds sometimes have a tough time keeping up with their glasses,” she said.

State-level officials have more control over the health care covered by CHIP compared with what’s covered by Medicaid.

In Pennsylvania, health law advocates say the Corbett administration has eroded CHIP benefits in recent months.

CHIP puts a cap on dental care, for example. That means the program stops paying when a child’s expenses reach $1,500.

“For 98 percent of the children, that’s absolutely fine. But for the worst cases — those children who need the most dentistry — it can go way beyond that, and of course these parents cannot afford it,” according to pediatric dentist Mark Goldstein.

Corbett predicts that switching kids from CHIP to Medicaid will confuse families, and he said in a letter to U.S. Health and Human Services Secretary Kathleen Sebelius that kids in CHIP have access to more hospitals and doctors.

Goldstein, who cares for low-income kids in Philadelphia, accepts both CHIP and Medicaid, but admits he’s heard complaints about Medicaid from other dentists.

“The usual things are that there is more difficulty getting qualified to Medicaid through the state,” Goldstein said. “Typically the fees are somewhat lower. As a consequence, they don’t want to deal with the program.”

Community Legal Services, a nonprofit group in Philadelphia, praises the CHIP-to-Medicaid move in a new analysis. That group’s report does not match the numbers offered up by the Corbett administration, and suggests that a “a relatively small number of kids will be transferred from CHIP to Medicaid.”

“Currently, 1.1 million Pennsylvania children are covered by Medicaid, while 188,000 are covered by CHIP. Effective 2014, 40,000 children in families between 100 and 133 percent FPIG [the Federal Poverty Income Guidelines], must be moved to Medicaid,” it said.