Archive for August, 2014


PA to Join Medicaid Expansion States

Pennsylvania’s request for federal approval of its Medicaid expansion plan has been approved by the federal government.

The plan, part of the Corbett administration’s “Healthy Pennsylvania” health care reform proposal, calls for an expanded population of Pennsylvanians who are newly eligible for Medicaid to obtain subsidized coverage through the private health insurance market – managed care organizations approved by the state to serve the new Medicaid expansion population.

A letter of approval from Centers for Medicare & Medicaid Services (CMS) administrator Marilyn Tavenner to Pennsylvania Department of Public Welfare Secretary Beverly Mackereth and a second document describing the special terms and conditions the federal government has attached to the waiver approval can be found here, on the Healthy Pennsylvania web site.…

500,000 at Risk of Losing New Health Insurance

About 500,000 people newly insured through the Affordable Care Act may lose their health insurance at the end of September if they cannot prove their eligibility for that insurance.

Most of the cases being reviewed involve whether the newly insured are living in the U.S. legally.

Currently, federal officials are reviewing information provided by 200,000 people but another 300,000 have not responded to requests for information about citizenship, immigration status, or income.  About one-half of those affected reside in Texas and Florida.

The affected people have until September 5 to provide the requested information.  Those who fail to do so, and those who do not meet the requirements, will lose their health insurance as of September 30.

Learn more about this situation in this New York Times article.…

Hospitals, Charitable Groups to Pay Insurance Premiums?

Hospitals and charitable groups such as the United Way are exploring the possibility of paying the health insurance premiums of uninsured patients who come through hospital doors.

Such an approach would enhance access to care for the uninsured while helping hospitals get paid for care they will be providing regardless of whether the patients in question have health insurance.

Such a practice is not entirely new.  A United Way organization in Wisconsin raised $2 million to help low-income residents purchase health insurance and hospital groups in New York and Florida are exploring a similar approach.

Health insurers oppose the idea, maintaining that hospitals selectively choosing whom to help will skew the pool of insured people toward those with greater health problems that incur greater costs to serve.

The federal government has not been clear about its perspective on the idea of anyone other than those seeking insurance paying their own premiums. While it requires insurers to accept premiums paid by selected federal programs, it issued an FAQ last year discouraging hospitals from taking the same approach.  Regulations issued after that FAQ, however, did not fully clarify the federal position.

Learn more about the issue, how such payments work, and the …

Charity Care? Wait a Minute

Many hospitals are considering whether they should continue to provide charity care to people who were eligible for Affordable Care Act subsidies to purchase health insurance but chose instead to remain uninsured.

The issue for many is whether the availability of charity care is an inducement for some people not to purchase health insurance and whether such patients are unwilling or unable to pay for care.

Some hospitals have decided not to provide non-emergency charity care to those who chose not to purchase subsidized health insurance.  Others are currently considering whether they need to revise their approach to charity care.  Still others have decided that they will not change their charity care policies.

Learn more about this latest phase in the evolution of charity care and how hospitals are approaching it in this Kaiser Health News report.…

Free Clinics Jumping Into Medicaid

Across the country, many free clinics that have long served the uninsured are becoming Medicaid providers.

Not to be confused with federally supported community health centers, these clinics have long been an important part of the health care safety net, and today, many are keeping their doors open, and billing Medicaid for their services, as part of an effort to ensure that their long-time patients still have access to care in communities that may not have many physicians who accept Medicaid patients.

Across the country there are about 1200 such free clinics, and while many are shutting their doors, others are changing how they do business to keep pace with the times.

Learn more about these free clinics and their evolving role in the post-Affordable Care Act era in this Kaiser Health News report.…