Written by Katie Carpenter
Dec 6, 2013 4:29 PM
Consumers who seek health insurance through the new marketplace may qualify for: Free or low-cost coverage through public coverage programs like Medicaid and CHIP.
Here's an update on Medicaid in PA:
As drafted, the federal Affordable Care Act (ACA) envisioned across-the-board Medicaid expansion to cover adults with incomes up to 133 percent of the federal poverty line.
But a 2012 ruling from the US Supreme Court made Medicaid expansion optional for states, and Pennsylvania is one of more than 20 states that have not taken the option.
For states that opt-in to an expanded Medicaid program, the federal government is pledging to pick up 100 percent of the tab for the first three years. After that, the feds would cover 90 percent of the costs in the out years.
But Governor Corbett has questioned the sustainability of that plan since his February 2013 budget address.
Corbett says 1 in 6 Pennsylvanians is currently receiving Medicaid benefits, and that would jump to 1 in 4 under the ACA's expansion plan.
In September 2013 the governor proposed a plan to use federal Medicaid expansion dollars to subsidize private health insurance for Pennsylvanians who are living below 133 percent of the federal poverty line.
The Corbett administration says the new program would allow 520,000 low-income Pennsylvanians to shop for private insurance on the online marketplace that opened in October.
Federal funding would help subsidize such plans. Private option enrollees would pay monthly premiums based on their income, and could reduce the payments if they participate in wellness programs.
The so-called “Healthy PA” plan would also make changes to Pennsylvania’s existing Medicaid program, including a work-search requirement for most working-age recipients.
Negotiations between the Corbett administration and the federal government are ongoing as of December 2013.
In the meantime, an estimated 400,000 Pennsylvanians living below the poverty line have fallen into a gap in which they qualify for neither Medicaid coverage nor financial assistance on the health insurance exchange. They are currently exempt from the individual insurance mandate under the ACA.
Follow our continuing coverage on Medicaid in Pennsylvania at Transforming Health.
This update written by Matt Paul- witf Reporter/Producer