Archive for Pennsylvania Medical Assistance


Pennsylvania Medicaid Expansion Begins

Pennsylvania has taken the final steps toward becoming the 29th state to expand its Medicaid program as provided for in the Affordable Care Act.

As of December 1, uninsured Pennsylvanians with an income less than 138 percent of the federal poverty level began enrolling in health insurance plans under the state’s Healthy Pennsylvania Medicaid expansion.

The official date on which enrollment began is December 1 in anticipation of the program’s official implementation on January 1.  During this period, an estimated 600,000 eligible Pennsylvanians may choose private insurers through which to receive health care coverage, with their premiums to be paid with federal Medicaid funds.

While the program is expected to begin as scheduled on January 1, it is not clear how long it will last in its current form.  Governor-elect Tom Wolf has expressed opposition to the approach taken by the Corbett administration through Healthy Pennsylvania and envisions a more traditional expansion of the state’s Medicaid program.  Whether Mr. Wolf will pursue such an approach, and when he might do so, remains unknown.

For a closer look at the Healthy Pennsylvania launch and the immediate future of Medicaid expansion in Pennsylvania, see this Pittsburgh Post-Gazette article.…

Medicaid Expansion in PA: What Happens Now?

Pennsylvania Governor Tom Corbett’s “Healthy Pennsylvania” health care reform program calls for his state to expand its Medicaid program on January 1 through a private insurance market option in which people choose private insurance plans through which to receive the Medicaid benefits for which they are newly eligible.

But Pennsylvania Governor-elect Tom Wolf wants to expand the state’s traditional Medicaid program and not employ the private insurance market coverage.

Governor Corbett will still be in office when his program is set to take effect on January 1, 2015.  Mr. Wolf will not take the oath of office until January 20.

The Philadelphia Inquirer takes a look at how Pennsylvania’s private insurance market option came about and what may happen next.  See its story here.…

PA Medicaid Expansion Hampered by Lack of Providers

The insurers selected to participate in Pennsylvania’s Medicaid expansion program are having a hard time persuading hospitals and doctors to join their provider networks.

Citing low Medicaid reimbursement rates, providers have been reluctant to work with the chosen insurers.

The state selected nine insurers to offer Medicaid coverage to approximately 600,000 new recipients beginning on January 1, but now, one of those insurers has withdrawn from the program and another is considering reducing the geographic region it intends to serve.

Originally, state officials said they hoped to have at least three insurance options in each of the nine regions created for the Medicaid expansion program.  Now, it appears that two carriers per region is a more realistic expectation.

Read more about the challenges insurers are encountering in lining up participating providers, and how that problem could affect the overall Medicaid expansion effort, in this Pittsburgh Tribune-Review article.…

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.…

States Using Reform Law to Experiment

A number of states are taking advantage of flexibility written into the Affordable Care Act to experiment with different ways to purchase, deliver, and pay for health care.

Vermont, for example, is considering a single-payer program in which all state residents would enroll in a state-run health insurance program.  Maryland and Massachusetts are setting health care spending targets and penalizing providers that exceed those targets.

Medicaid has inspired a number of state experiments as well.  Wisconsin seeks to enable higher-earning Medicaid recipients to leave Medicaid, taking with them tax credits that will enable them to purchase affordable health insurance in the private marketplace.  Arkansas, Iowa, and Ohio are having new Medicaid recipients purchase private insurance using federal Medicaid dollars, with Pennsylvania and Utah now seeking permission to do the same.

Read more about states as a laboratory for health care innovation, and find a map with the latest information on where states stand on Medicaid expansion, in this Wall Street Journal article.…