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‘You feel helpless’: What would Medicaid spending cuts mean for Lancaster County students?

08/07/2017 LancasterOnline By Alex Geli

For Aaron Freas, the very breaths he takes may not be possible without Medicaid.

Freas, a 19-year-old student at Lampeter-Strasburg High School who suffers from a complicated case of spina bifida, is one of the many students in the county who rely on Medicaid services both at home and in school.

If spending for the federal medical assistance program was cut, as many federal lawmakers have proposed in recent months, families such as Freas’ as well as school districts who benefit from it would be fettered by a gaping funding hole. In the school districts’ case, that would likely be filled by taxpayer dollars. 

“You feel helpless,” Freas’ mother, Janene, said. “We try to get our voice out there and say this matters. We’re not sure how else to do that.”

Living with spina bifida

Aaron Freas was diagnosed with spina bifida — a birth defect where the spinal cord isn’t fully developed, paralyzing the body from the undeveloped spot on down — before he was born.

He needs a ventilator to breathe, a gastrostomy tube for nutrition, a wheelchair to get around and an electronic device to speak.

Medicaid helps provide nursing services while he sleeps and when he’s in school, as well as medical equipment and other services.

Through all of it, Al Freas says his son has kept a positive outlook.

“You would think he deserves to possibly be a little upset ... but there’s just not a drop of that in his personality,” he said. “If he can be happy, and he is, really anybody should be able to.”

Medicaid benefits

Every year, Pennsylvania school districts and intermediate units can apply for Medicaid reimbursements through the state. That money helps serve students with special needs and who are eligible for medical assistance.

In 2015-16, Lancaster County school districts, as well as the Lancaster-Lebanon Intermediate Unit 13, received $3.1 million from Medicaid, according to the latest data from the Pennsylvania Department of Education. Most of that comes from Medicaid’s School Based Access Program. The rest — about $267,000 — stems from administrative support funding.

The IU receives reimbursements for its preschool early intervention program, which provides developmental services to more than 3,000 special needs children annually in Lancaster and Lebanon counties, spokewoman Shannan Guthrie said.

Between that, and helping school districts apply for Medicaid funding, the IU processed more than 125,000 reimbursement claims last year, Guthrie said.

Matt Przywara, chief operating officer at School District of Lancaster, said the application process is often time consuming, but the money is “absolutely beneficial” and “hugely impactful for the students.”

SDL, the county’s largest school district, benefited the most from Medicaid in 2015-16. It received $852,724 in reimbursements that year, and nearly $10 million in the last 10 years, Przywara said. If that money was trimmed or cut outright, he said, that gap would be filled “by the general fund and the taxpayer dollar.”

By law, school districts would have to make up the cost, said Danielle Pfautz, assistant director of special services at Cocalico School District.

“Special education costs — they’re expensive,” she said. “The money has to come from somewhere.”

Cocalico received $310,475 in Medicaid reimbursements in 2015-16, the county’s second-highest district total. Pfautz said she’s concerned about what would happen if that funding stream was to dissipate.

“I think it’s concerning for everybody all around, especially for the people actually living it,” she said. “The people making decisions (lawmakers) aren’t necessarily living it.”

Pleading with lawmakers

The Freas family has met with several lawmakers, including Republican state Rep. Keith Greiner and Republican U.S. Rep. Lloyd Smucker, to emphasize Medicaid’s critical presence.

In May, Smucker voted in favor of the American Health Care Act, which the Congressional Budget Office reported would create major cuts in Medicaid enrollment and spending. The bill, which passed the House but didn’t advance through the Senate, would have resulted in 14 million fewer people enrolled in the program by 2026 as well as $834 billion in spending cuts over a decade.

The former businessman has since worked with a group of Republicans and Democrats called the Problem Solvers Caucus to propose a bipartisan health care solution.

Smucker — who serves Pennsylvania’s 16th District, which includes Lancaster County — was unavailable for comment.

“When people talk about cuts to Medicaid, they’re cuts to everybody,” Al Freas said. “It calls us to action, at least to try.”

The Freas family posted a video to Instagram and Twitter, calling on legislators to compose a bipartisan plan that improves health care without making cuts to Medicaid.

The Instagram post read, in part: “I’m Aaron. Please hear my voice. Together, we can #savemedicaid.”

Only time will tell if lawmakers decide to listen.

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