Free Clinic Association of PA Annual Conference

1. Free Clinic Association of PA Annual Conference What’s Happening in Harrisburg—Budget, MA Expansion, SB 5 May 3, 2013 Harrisburg, PA

2. Contact Information Anne Hart 20 North Market Square, Suite 800 Harrisburg, PA 17101 717-214-2200 hart@thebravogroup.com

3. Healthcare Reform in PA

4. What’s Been Done • PA Fair Care • ACA Based Plan for Uninsured with Pre-Existing Conditions • Premise was Bridge to 2014 • About 6,845 enrollees (estimated 7,500 enrollees) • PPO - $283 a month • CMS suspended all new enrollment

5. What’s Been Done • ACA Provides for limited HHS review of individual and small group market segments (Act 134 amends Title 40) • Coverage and Policy Changes • Annual and lifetime limit prohibition • Dependency Age 26

6. What’s in the Works • PA E-Health Partnership Authority • Created through legislation approved in July 2012. • The purpose of PEPA is to enable the secure exchange of health information • PA awarded 17.1 million under ARRA to establish a health information exchange. • Currently working with stakeholders • http://paehealthcollab.com/index.html

7. What’s In the Works • Insurance Exchange • PA has deferred to the feds to establish an exchange (marketplace)

8. MA Expansion • Governor Corbett has not said “no,” but funding not included in proposed budget. • Corbett met with CMS officials • CMS will consider PA a non-expansion state so that the state would receive 100% reimbursement for the first three years • Governor wants more flexibility for the newly eligibles • Specifically, co-pays, deductibles, work requirements

9. MA Expansion (Con’t) • Reports supporting expansion: Rand (HAP), PA Economy League (PA Health Funders Collaborative), PA IFO • Rely on Gross Receipts Tax (GRT) to make numbers work • Feds to issue national guidance on revenue enhancements (assessments/GRT)

10. SB 5 • Creates Community Based Health Care Program • Hospital clinics administered thru DPW • Grants require a 25% matching commitment. • No more that 15% awarded to one city, town, township in PA, and FQHCs limited to 25% • DoH to distribute funding as follows: • Up to 50% for expansion of existing clinic or new clinic • Up to 25% for improvements in prenatal, OB and newborn care • Up to 20% for improved services to reduce unnecessary emergency room utilization • Up to 5% for collaborative relationships among providers

11. How to Speak to Legislators

12. “When you need a friend, it’s too late” ~ Mark Twain

13. “Politicians work just as hard at survival as any business.” ~ Chris Bravacos

14. Lobbying Legislators

15. Know thy legislator • Biography (look at their website) • Voting record on topics • Mutual friends • Visit in office in district • Attend local fundraisers

16. Know Thyself • You are a constituent • You are a taxpayer • You are a voter • Your are an employer • You are a caregiver

17. Be Clear About Your Request • Assume legislators/staff know little or • nothing about free clinics—don’t be • jargony and use simple language • Your job is to inform, educate and ASK • Their job is to REPRESENT

18. Explain issue in terms they can understand • Why is it their interest to support our position? • Idea is popular • It fulfills a campaign pledge—health care reform • They can make their mark with this issue

19. Always tell the truth

20. Two responses to a question… • The answer. • I’ll find out.

21. Listen close to answer “Yes” sounds like: “I agree, and will support that.” “No” sounds like: “I’m with you but hope it doesn’t come up for a vote.” “I don’t want the committee to consider this legislation.” “You make some good points.” “I don’t see you enough…at my fundraisers.” “Send me more information.” “Your son/daughter was great in that game yesterday.” “I do not support…but might not oppose.”

22. Thank You