U.S. senator: Other places should replicate Franklin County's health coverage strategy

Franklin County's strategy for securing health care for groups that would otherwise lack it should serve as a model around Pennsylvania, according to U.S. Sen. Bob Casey. 

The Democratic lawmaker was at Chambersburg Hospital Friday to discuss the challenges rural hospitals face. 

The county is unique in that its uninsured rate is not the result of poverty, but rather due to the prevalence of individuals who cannot easily access coverage, or refuse it altogether, explained Kimberly Rzomp, chief financial officer of WellSpan-Summit Health. At 7.4%, the county's poverty rate is well below what exists across the state (8.9%) and nation (10.5%).

At the same time, nearly 13% of children under 6 are uninsured in the county, while under 5% across the state and nation face the same struggle. Driving the local rate is the number of children of undocumented parents and the number of Amish, Mennonite and other fundamentalist families, which often have a larger number of children. The fundamentalist population is also the driving factor behind 12.3% of white, non-Latino people in the county lacking insurance. 

More:Sen. Casey: Repeal of Obamacare targets rural Pa.

Keystone Health has put in considerable effort to reach and provide care to these folks, according to Rzomp. She explained that Keystone offers a reduced-pay plan to the fundamentalist patients who refuse any government-provided coverage. For the often-illiterate farm workers and the children of undocumented parents who fear announcing their status to the government or don't know they have a coverage option at all, the organization offers navigators to help folks through the application process. 

Casey said he cannot recall ever seeing a data survey from a county like the one Summit-WellSpan provided, and suggested replicating it throughout the state. It shows that the local health professionals are putting in the work to tackle the big challenges before them. 

"You have barriers to surmount that some counties don't," he said. 

But more barriers could be on the horizon

Rural hospitals, which Chambersburg is considered to be, could be in trouble down the road if Congress does not put in the work to improve health care coverage around the country, Casey said. He lamented actions Republicans have taken to dismantle the Affordable Care Act, even though he does not think the ACA did enough to lower costs. 

"This is hard. There aren't nine ways to do health care at the federal level. There might be one or two, and the Affordable Care Act was an imperfect but substantially positive leap forward."

A district court has already ruled in the favor of 18 Republican attorneys generals who filed a lawsuit arguing the ACA - commonly known as Obamacare - is unconstitutional, and Casey thinks the appeals court it currently sits before will uphold that ruling. He has little doubt the U.S. Supreme Court - with its new 5-4 conservative majority - would rule the same, should the suit get there. 

More:Obamacare enrollment: More plans are available to Franklin County people for 2019

Preserving funding to Medicaid and Medicare is crucial for the country, Casey said. He pointed out that, while it had no chance of passing, the Trump administration's proposed budget included $1.5 trillion in cuts to Medicaid and $845 billion in cuts to Medicare. 

Largely because of Medicaid expansion in the ACA, nearly 280,000 people in Pennsylvania obtained health coverage, Casey said. Around 10% of people in Franklin County are part of that group. 

"Why am I sounding the alarm if this is just a potential result in a lawsuit or a potential budget cut? Why am I raising the alarm? We have to be ready. We have to be on a war footing when it comes to health care."