Waiver to use Medicaid money for private insurance approved
Ben Allen and The Associated Press | 08.28.14
Photo by AP Photo/Marc Levy
In a file photo from September 2013, Governor Corbett announces that he will seek federal Medicaid expansion money to extend health insurance to an estimated 520,000 working-age adults.
The federal Centers for Medicare and Medicaid Services has approved Pennsylvania's request to use federal money to buy private insurance for the poor. More than 600,000 people would be eligible for coverage, according to the Corbett administration. Enrollment starts December 1, with coverage taking effect January 1, 2015. Low-income childless adults primarily will gain the coverage.
Those making more than 100% of the federal poverty level, $23,850 for a family of four, would have to pay two percent of their income towards a monthly premium, starting in year two. In that year, payments could be reduced based on "job training", "work-related activities", or an annual wellness visit.
An $8 co-pay will be added to any emergency room visits for "non-emergency use".
His administration backed off a work-search requirement since the application was submitted, but the plan cuts aid for the disabled.
Pennsylvania the 27th state to accept Medicaid expansion money under the landmark 2010 federal health care law. The money became available last Jan. 1.
Corbett is facing an uphill battle to win re-election Nov. 4.
Dr. Bruce MacLeod, President of the Pennsylvania Medical Society, issued the following statement:
"Federal officials have approved a waiver to expanding Medicaid that will allow Gov. Tom Corbett’s state-specific health insurance solution to move forward and provide coverage through the state’s Healthy PA initiative.
The initiative should aid more than 600,000 Pennsylvanians through private, commercial insurance that includes national standards around essential health benefits, mental health parity, and preventive care. Benefit packages are anticipated to be similar to those provided in the commercial market to working Pennsylvanians through their employers.
Since the very first mention of health care reform, the Pennsylvania Medical Society has supported efforts to expand access to affordable, quality health insurance. While many have debated the method to expand healthcare at both the federal and state levels, the Pennsylvania Medical Society has focused on the end-result - getting more Pennsylvanians access to health insurance.
The Pennsylvania Medical Society looks forward to working with Governor Corbett and his administration on the implementation of the Healthy PA waiver and other efforts to expand access to affordable, quality health care across the state."
The Pennsylvania Health Access Network also released a statement:
“Today’s agreement begins to dig Pennsylvania out of the hole Governor Corbett and lawmakers created when they rejected funding to expand health care coverage to half-a-million low-income Pennsylvanians. There never should have been a coverage gap in Pennsylvania, and we share the relief of hundreds of thousands of uninsured Pennsylvanians in knowing it’s finally on track to close.
However, serious concerns remain about the affordability of premiums and new bureaucratic hurdles under Healthy PA, and the drastic cuts Pennsylvania is seeking to make in our existing Medicaid program. If approved, these cuts will jeopardize the health of people with disabilities, pregnant women and seniors.
Unlike all of our neighboring states, which used new funding in the Affordable Care Act to cover low-income individuals and families right away, Pennsylvania took a detour to pursue the complex and controversial Healthy PA waiver. Delaying action on Medicaid Expansion has already cost the Commonwealth $4.8 million per day in federal funding since January 1st that could’ve been creating jobs and strengthening our rural and community hospitals.
While we applaud CMS for removing the most harmful aspects of Healthy PA, we still believe Medicaid Expansion would have been the best choice for Pennsylvania.
Advocates will remain vocal and vigilant to protect quality care and critically important benefits for low-income Pennsylvanians as this process moves forward. We look forward to working with State and Federal officials as negotiations over benefits continue and implementation of Healthy PA begins.”