Pennsylvania reaches deal to expand Medicaid to low-income earners

Pennsylvania became the 27th state to expand Medicaid guidelines in exchange for receiving federal dollars, after the US Department of Health and Human Services on Thursday approved the state's plan.

A half-million more low-income Pennsylvanians are in line to get federally funded health insurance after the U.S. Department of Health and Human Services on Thursday approved the state's plan to accept Medicaid expansion money under the landmark 2010 federal health care law.

Republican Gov. Tom Corbett's administration and the federal agency agreed to a plan that lets private insurers administer Medicaid-funded coverage that adheres to Medicaid's existing rules. The plan vastly expands a Medicaid program that already covers 2.2 million adults and children in Pennsylvania.

Enrollment in the plan, named Healthy Pennsylvania, is expected to begin Dec. 1 with coverage to start the following Jan. 1. With the agreement, Pennsylvania joins 26 other states and Washington, D.C., in opting for the Medicaid-funded expanded coverage.

Corbett was under pressure from hospitals, labor unions, the AARP and advocates for the poor to accept the Medicaid expansion money, which became available Jan. 1 of this year. They argued it would cover hundreds of thousands of low-income working adults.

The governor, a critic of President Barack Obama's signature health care law, initially refused to accept the federal money without changes to the Medicaid expansion as it was envisioned by the law. He proposed ways to make the Medicaid coverage more like private insurance, including waiving some of the program's permissive coverage rules. He ultimately made some concessions in the final agreement, as he faces a tough re-election bid this November.

Corbett faces Democratic challenger Tom Wolf, who criticized the governor for delaying the expansion of health care.

Corbett is the ninth Republican governor to agree to expand Medicaid guidelines in exchange for receiving federal dollars. Most of the 27 states in the program simply expanded the eligibility guidelines of their Medicaid programs on Jan. 1. Like Pennsylvania, a few states, including Arkansas, Iowa and Michigan, sought changes to the program.

The expansion will be paid for with 100 percent federal funds through 2016. Federal funding gradually declines beginning in 2017 to 90 percent of the cost. Still, Pennsylvania will save billions of dollars over the coming years by shifting tens of thousands of existing Medicaid enrollees onto the federal government's tab.

Under the approved plan, incentives will be offered to enrollees to lower their premiums. And while premiums and co-pays are relatively small, enrollees could be denied coverage or service if they fail to pay in a timely fashion.

"We're trying to show that by giving individuals personal responsibility in building in healthy behaviors that we're not just trying to do what we've always done," said Beverly Mackereth, Corbett's Department of Public Welfare secretary. "We're trying to build a program that changes behavior and allows people to benefit more from the health care that they're given."

But the U.S. Centers for Medicaid and Medicare Services said federal rules that apply to other private Medicaid providers will not be waived, although Pennsylvania can rely on commercial standards if they are at least as stringent as the federal rules. Private insurers already administer coverage for many of Pennsylvania's existingMedicaid enrollees.

Marilyn Tavenner, head of the Centers for Medicaid and Medicare Services, praised the Pennsylvania deal and said federal health officials are committed to working with states on innovative solutions. She also noted that millions more Americans are still without Medicaid coverage because their states have yet to embrace a Medicaid expansion.

Corbett's 124-page plan, submitted to federal officials in February, asked CMS to break new ground on Medicaid policy, including a first-of-its-kind work requirement for recipients to be eligible for Medicaid benefits under the expansion.

But his office ultimately backed off several of his proposals, including a request to make the Medicaid-funded coverage free of some of Medicaid's more permissive coverage rules. Before negotiations began in April, Corbett also dropped one of the more disputed conditions to require able-bodied, working-age Pennsylvanians to complete certain work-search activities to be eligible.

The program will now be voluntary, and enrollees can lower their premiums via a state plan by showing that they are working at least 20 hours a week or are engaged in skills training or certain job-searching activities.

Corbett's proposal covered the same population as the Medicaid expansion: working adults who make up to 133 percent of the federal poverty level, or about $15,500. Corbett administration officials say more than 600,000 more residents — primarily low-income childless, working adults — will be eligible for the coverage. About 50,000 are already enrolled in the existing Medicaid program, and administration officials say they cannot project how many ultimately will enroll.

----

Yen and Associated Press writer Ricardo Alonso-Zaldivar contributed to this report from Washington, D.C.

You've read  of  free articles. Subscribe to continue.
Real news can be honest, hopeful, credible, constructive.
What is the Monitor difference? Tackling the tough headlines – with humanity. Listening to sources – with respect. Seeing the story that others are missing by reporting what so often gets overlooked: the values that connect us. That’s Monitor reporting – news that changes how you see the world.

Dear Reader,

About a year ago, I happened upon this statement about the Monitor in the Harvard Business Review – under the charming heading of “do things that don’t interest you”:

“Many things that end up” being meaningful, writes social scientist Joseph Grenny, “have come from conference workshops, articles, or online videos that began as a chore and ended with an insight. My work in Kenya, for example, was heavily influenced by a Christian Science Monitor article I had forced myself to read 10 years earlier. Sometimes, we call things ‘boring’ simply because they lie outside the box we are currently in.”

If you were to come up with a punchline to a joke about the Monitor, that would probably be it. We’re seen as being global, fair, insightful, and perhaps a bit too earnest. We’re the bran muffin of journalism.

But you know what? We change lives. And I’m going to argue that we change lives precisely because we force open that too-small box that most human beings think they live in.

The Monitor is a peculiar little publication that’s hard for the world to figure out. We’re run by a church, but we’re not only for church members and we’re not about converting people. We’re known as being fair even as the world becomes as polarized as at any time since the newspaper’s founding in 1908.

We have a mission beyond circulation, we want to bridge divides. We’re about kicking down the door of thought everywhere and saying, “You are bigger and more capable than you realize. And we can prove it.”

If you’re looking for bran muffin journalism, you can subscribe to the Monitor for $15. You’ll get the Monitor Weekly magazine, the Monitor Daily email, and unlimited access to CSMonitor.com.

QR Code to Pennsylvania reaches deal to expand Medicaid to low-income earners
Read this article in
https://www.csmonitor.com/USA/Latest-News-Wires/2014/0828/Pennsylvania-reaches-deal-to-expand-Medicaid-to-low-income-earners
QR Code to Subscription page
Start your subscription today
https://www.csmonitor.com/subscribe