Page 11 - 2018PHAVoterGuide

Denny Wolff (D)
I believe Congress should continue to provide funds for Medicaid recipients that use
home-based care. I would advocate for training in our trade schools, community col-
leges, and nursing programs, so those on home-based care are able to easily find care
to meet their needs. I would also support incentives that allow health care providers to
use new practices and technologies that cut down on costs. I would support allowing
Medicare to expand to in-home personal care. If elected, I would support bills like HR
1825.

District 10 – Cumberland (part), Dauphin, York (part)

Scott Perry (R) (Incumbent)

Making reforms to Medicaid and its coverage of home-based care is largely a question
for the Pennsylvania State Legislature. Medicaid is a joint federal-state program. While
the federal government requires states to cover certain mandatory populations and
benefits, the states have broad flexibility to cover other optional populations and
services. One of the first reforms we can make is increasing efficiencies and reducing
costs in how care is delivered. A good example is H.R. 1825 – Home Health Care
Planning Improvement Act, which would reduce the time, energy, and cost for health
care providers to order home health care for patients who need it.

Medicare is for medically-necessary care, and could be expanded to include the efficiencies of home
care if budgets allow. For patients that have medically-necessary care, Medicare will cover the cost of an
aide. Medicare currently covers in-home care that centers on the skilled and necessary care. In 2016, 3.5
million Medicare beneficiaries received home health care and 110 million visits were made.

George Scott (D)
Medicaid is a vital program that provides health care access to our nation’s most
vulnerable populations. The majority of Medicaid recipients are children, disabled,
elderly, or individuals who live below 133% of the federal poverty line despite working
full- or part-time jobs. We must preserve and protect Medicaid’s fundamental program
structure while still seeking innovative reforms in areas such as home-based care.
In 2017, the U.S. House of Representatives passed the American Health Care Act
(H.R. 1628), which capped Medicaid spending and allowed the program to be turned
into a block grant. This was the wrong approach, as it would have limited patient
access to home-based as well as inpatient care and would have reduced overall
cost reimbursements to health care providers. Fortunately, the U.S. Senate opted not to consider this
misguided piece of legislation. I oppose capping federal Medicaid spending or transforming Medicaid
into a block grant program because economic fluctuations and our rapidly aging population require the
flexibility that the program’s current structure provides. I support maintaining the federal government’s
current Medicaid cost-sharing floor of 50 percent. Health care providers, patients, and state governments
need this structure in order to plan accordingly and achieve the best outcomes.

I also support initiatives to expand access to home-based care under Medicaid because home-based care
often reduces costs without sacrificing outcomes and has been shown to increase patient satisfaction. It
currently takes between six and nine months to fully process a Medicaid application, which often delays
access to care for those who need it the most. Expanding Medicaid presumptive eligibility to include
home-based care, for example, would be one method of overcoming this obstacle. Congress should
explore expanding Medicare to include in-home personal care. Medicare currently pays for in-home
personal care services only under a limited set of circumstances if individuals qualify for “skilled care” 11