HARRISBURG -- Gov. Tom Corbett is pressing the federal government for an exemption that he said will prevent about 70,000 Pennsylvania children in a state-subsidized health insurance program from having to switch to Medicaid, although a public interest law center challenging the governor's claims said the children will be better off under Medicaid.
Mr. Corbett wrote Thursday to U.S. Health and Human Services Secretary Kathleen Sebelius about his latest request, part of his effort to press her agency to make enough concessions to a federally funded expansion of Medicaid before he will change his mind and allow Pennsylvania to join it.
A Sebelius spokesman did not comment on the letter Friday. However, Community Legal Services of Philadelphia, a public interest law center that advocates for the poor, disputed Mr. Corbett's claims, including his core complaint that some families will have to switch doctors and will have a smaller choice of doctors that they can visit.
For most kids, moving to Medicaid from the Children's Health Insurance Program, or CHIP, will not cause significant disruptions, a Community Legal Services lawyer said Friday.
The lawyer, Richard Weishaupt, said it is already common for families to move between the programs if, for instance, there is a change in the parent's income or the parent loses their job. Virtually all CHIP health insurance companies have a Medicaid product, including the state's four nonprofit Blue Cross/Blue Shield insurers.
"It's just a question of switching them from one product to another," Mr. Weishaupt said.
Still, Pennsylvania could simply require that doctors and hospitals that accept CHIP also accept Medicaid, he said. Many other states have subsidized children's health insurance programs, but governors are not clamoring over the requirement that children switch to Medicaid beginning in 2014.
In any case, Medicaid is better for families than CHIP, Mr. Weishaupt said.
Medicaid covers all medically necessary services, while CHIP provides more limited coverage, which is fine if a child is normal and relatively healthy, Mr. Weishaupt said. In addition, CHIP disqualifies any child with any other health coverage, he said.
"God forbid, if your child gets sicker than the normal stuff, then Medicaid is a better program," Mr. Weishaupt said.
Community Legal Services also challenged Mr. Corbett's estimate of the number of children who would have to be moved, saying there are 40,000 children who must be moved to Medicaid beginning in 2014.
In the letter, Mr. Corbett said his administration anticipates having to transfer about 70,000 children from CHIP to Medicaid.
Under the 2010 federal health care law, states must expand the eligibility limits of Medicaid for children ages 6 to 19 beginning in 2014, though CHIP in Pennsylvania already provides coverage to those children. The state government gets more money from the federal government to cover a child under CHIP than it does under Medicaid, and the law will maintain that higher reimbursement, Community Legal Services said.
About 1.1 million children are on Medicaid.
Since Mr. Corbett became governor, the number of children in CHIP has slid by about 6,000 to 187,000, with particular losses among the group of children for whom CHIP is free. Department of Insurance officials say they are unable to explain why the number of children who receive free CHIP care has declined.
A department spokeswoman, Rosanne Placey, said Friday that officials there believe overall awareness of the program is down because of a reduction in the amount of money available to market the program in recent years. Mr. Corbett is proposing to add money to the budget to improve CHIP's marketing for the year beginning July 1.