Concerning Medicaid, Patrick Keenan, director of Consumer Protections and Policy with the Pennsylvania Health Access Network said he is alarmed by proposals being made by lawmakers opposed to the Affordable Care Act in Congress. “Those proposals not only reverse or limit the expansion that we were able to take benefit of in Pennsylvania, but it actually goes to changing the heart of the Medicaid program and how it’s financed and how it’s structured. Most of the proposals would limit block grants and per capita caps. What they would basically do is upset the Medicaid apple cart.”

That means that states would no longer have to comply with certain standards and could impose any changes they wanted. “Everything would be up for grabs, and Medicaid could no longer be an entitlement program.”  Keenan believes it is likely that protections and standards would not be required any longer by the state administered programs, and they would no longer be obliged to cover as many groups and types of individuals. That would include folks like seniors, persons with disabilities, children, and pregnant women. “It would be not just rolling back the ACA; it’s actually rolling back decades of progress we have made in Pennsylvania,” Keenan said.

In terms of Medicare, Keenan said that “the Affordable Care Act made huge improvements for seniors and other persons who rely on this income. Unfortunately the best kept secret about the ACA are those improvements. What it did was lowered prescription drug costs, as well as makes sure that seniors are getting more financial help and resources.”

The ACA also monitors the numerous Medicare advantage plans, the private HMO-esque plans, through the implementation of a ratings system to make sure only high quality plans are offered. Under the ACA, if plans do not meet certain standards, they can no longer be sold. Keenan says that PHAN wants to ensure that “Quality, timely care for seniors which is affordable remains available. The organization strives to create more innovative models to get seniors the care that they need in a responsible way.” Additionally, very often “at risk” seniors use a combination of Medicaid and Medicare. An overhaul of the ACA would place these most vulnerable seniors at risk.

“The Affordable Care Act is something that doesn’t just affect the 1.1 million Pennsylvanians that have been enrolled in coverage under the ACA, (but also) the 430,000 in the marketplace and 700,000 in Medicaid expansion,” Keenan said.