At request of counties, lawmakers delay privatization of Medicaid rides to doctor’s visits

Lawmakers successfully struck a compromise during June’s budget negotiations to delay the privatization of a program that transports low-income individuals to doctor’s appointments.

A last-minute provision added to the budget passed in 2018 mandated that the program, known as Medical Assistance Transportation, be contracted to a private company or companies. 

Currently, the program is run by Pennsylvania’s 67 individual county governments. It ferries 150,000 Medicaid recipients to everything from dialysis, therapy, and specialist visits.

Lawmakers agreed to privatize free medical trips for Medicaid recipients last year. Now, some are trying to stop it

The Department of Human Services sought contract requests this spring, but any further action will now be delayed by at least 180 days, or until December. The department will also issue a study on the impact of the switch, with a preliminary report due in September. 

Proponents of privatization — including Senate Appropriations Committee Chairman Pat Browne, R-Lehigh, and House Appropriations Committee Chairman Stan Saylor, R-York — have said the change could save money, bring in more federal dollars, and potentially fight fraud.

But county governments and public transit agencies raised concerns that taking the program out of public hands would lead to increased costs for seniors and disabled individuals who utilize similar programs to get to medical appointments.

That’s turned out to be the case in Texas, which privatized its program in 2013. Four years later, a report from Texas’ Legislative Budget Board found that contracting with private providers led to increased spending per trip and complaints.

Sheila Gombita, executive director of Washington County’s transit authority, said providing rides to medical appointments constitutes 36 percent of Washington Rides’ yearly service. 

“When you lose 36 percent of your business, you know it’ll have a negative impact on the others who use your service,” Gombita told the Capital-Star.

Lawmakers from both parties and across the state came out hard against the change earlier this year. 

In the lead-up to the budget’s passage, some House Republicans made a ruckus in caucus over the matter. Rep. Eric Nelson, R-Westmoreland, tried to delay privatization by tacking a provision on to a related bill earlier this year.

Nelson said the General Assembly now has a chance to avoid enacting a “less efficient and more expensive” program.

Sen. Lisa Baker, R-Luzerne, sponsored legislation to delay privatization that was instead folded into a code bill — or a piece of budget-enabling legislation.

Baker credited the outreach of constituents and organizations for forcing the General Assembly’s hand, and looked forward to using the report as a blueprint to either protect or make changes to the program as needed.

“If we’re operating inappropriately, then we need to know and we need to take steps to correct it,” she told the Capital-Star.

Douglas Hill, executive director of the County Commissioners Association of Pennsylvania, said he’s confident the study will show that the current system is already operating at peak efficiency.