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Gap in Reform Law Could Leave Many Low-Income People Uninsured

When the Supreme Court gave states discretion over whether to expand their Medicaid programs under the Affordable Care Act, it unintentionally created a gap in potential coverage options for many low-income people that may leave many of those people without affordable health insurance.
According to a new report from the Commonwealth Fund, the 2010 reform law anticipated that everyone with incomes below 133 percent of the federal poverty level would be covered by Medicaid.  Individuals and families with incomes between 133 percent and 399 percent of the federal poverty level could use new federal subsidies to help purchase private health insurance.
In states that are not expanding their Medicaid programs, people with incomes between 133 percent and 399 percent of the federal poverty level will still be able to take advantage of federal premium subsidies.  People with incomes less than 133 percent of the federal poverty level but who do not qualify for their state’s Medicaid program – qualification criteria vary from state to state – will not be eligible for the same subsidies as many who earn more than them because the reform law assumed that all such individuals would be covered by Medicaid.
According to the Commonwealth Fund, this unanticipated gap in the reform law means that as many as 42 percent of people who suffer from periodic or chronic lack of insurance and who live in states that are not expanding their Medicaid programs will not benefit in any way from Affordable Care Act insurance reforms.
Pennsylvania is one of the states in which this problem will occur because the state is not expanding its Medicaid program.  It almost certainly will require Pennsylvania’s safety-net hospitals to provide more uncompensated care than originally expected when the reform law was enacted.
Read more about the unintended consequences of the Supreme Court’s decision and the choice by some states not to expand their Medicaid programs in In States’ Hands:  How the Decision to Expand Medicaid Will Affect the Most Financially Vulnerable Americans, a new report from the Commonwealth Fund.

2013-09-09T06:00:22+00:00September 9th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on Gap in Reform Law Could Leave Many Low-Income People Uninsured

Medicaid Expansion to Ease Hospitals’ Uncompensated Care But Not in PA

Hospitals in states that expand their Medicaid programs under provisions of the Affordable Care Act should see a reduction in their uncompensated care once people begin applying for Medicaid benefits.
That will not be happening in Pennsylvania, however, because the state is not expanding eligibility for its Medicaid program.
In states that do expand their programs, hospitals will continue to lose money serving Medicaid patients because Medicaid payments seldom cover the cost of the services hospitals provide.  Demand for Medicaid services will grow in these states, moreover, as more people become eligible for benefits and some who have not had regular access to care for years begin to use their new benefits to address long-standing medical problems.
Recent published reports suggest that the Corbett administration is working on an expansion plan, to be negotiated with the federal government, and that this plan may be revealed to the public this fall.
Michigan became the most recent state to decide to take advantage of the Affordable Care Act and expand its Medicaid program.  For a look at how Medicaid expansion will affect hospitals in that state, see this Detroit Free Press articleHospital building.
 

2013-09-04T13:40:02+00:00September 4th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on Medicaid Expansion to Ease Hospitals’ Uncompensated Care But Not in PA

PA Inching Closer to Medicaid Expansion

Pennsylvania state officials are working on a proposal to expand Medicaid eligibility in the state as provided for in the Affordable Care Act.
But newly eligible Pennsylvanians would not participate in the state’s current Medicaid program.
Speaking to a rotary club in York, Department of Public Welfare Secretary Bev Mackereth told her audience that because the state lacks confidence in the willingness of the federal government to continue funding care for new Medicaid enrollees, the state is developing a plan to present different Medicaid options to newly eligible people.
State officials continue to negotiate the terms of such a program with the federal government and anticipate submitting their proposal to the federal government in the near future.  If approved, they do not anticipate launching such an initiative until at least January of 2015.
Read more about the state’s plans in this Calkins Media report.

2013-08-30T06:00:24+00:00August 30th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on PA Inching Closer to Medicaid Expansion

PA Gets Navigation Money

Pennsylvania has received $2.7 million in Affordable Care Act money to help individuals and families navigate the health insurance exchange that the federal government will operate for the state beginning on January 1, 2014.
The money will be divided among five groups that will help individuals figure out how to take advantage of the new health insurance exchange and obtain any insurance premium subsidies for which they may be eligible.
The five groups receiving the federal money are Resources for Human Development, the Pennsylvania Association of Community Health Centers, Mental Health America, the Pennsylvania Mental Health Consumers’ Association, and the Cardon Healthcare Network.
Learn more about the federal money, why it is being spent, and how it will be used in this PA Independent article.

2013-08-23T06:00:12+00:00August 23rd, 2013|Affordable Care Act|Comments Off on PA Gets Navigation Money

Insurance Subsidies Will Be Common

Nearly half of all individuals and families expected to turn to health insurance exchanges for insurance policies under the Affordable Care Act will be entitled to federal subsidies to help pay their premiums.
Those subsidies will average more than $5500 per family and cover two-thirds of a premium’s overall cost.
These subsidies will be critical for Pennsylvania’s safety-net hospitals, which currently find themselves providing significant amounts of uncompensated care to low-income but working individuals and families that cannot afford health insurance today.
These were among the findings of a recent Kaiser Family Foundation analysis.  Read more about the analysis and the future that awaits individuals and families in the new individual health insurance market in this CQ HealthBeat article presented by the Commonwealth Fund.

2013-08-22T06:00:31+00:00August 22nd, 2013|Affordable Care Act|Comments Off on Insurance Subsidies Will Be Common

PA Posts FY 2013 Medicaid DSH Eligibility

The Pennsylvania Department of Public Welfare has published a notice in the Pennsylvania Bulletin listing all hospitals eligible for Medicaid disproportionate share adjustments (Medicaid DSH) during the state’s 2013 fiscal year.  See the Pennsylvania Bulletin notice here.

2013-08-21T11:38:38+00:00August 21st, 2013|Medicaid supplemental payments, Pennsylvania Bulletin|Comments Off on PA Posts FY 2013 Medicaid DSH Eligibility

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has released its latest newsletter.
Features include articles about the state budget and the possible expansion of Medicaid eligibility in Pennsylvania; upcoming changes facing CHIP and PA Fair Care participants; an upcoming study on serving dual eligibles in the state; a new state Medicaid waiver application; and more.
Find the latest Pennsylvania Health Law Project newsletter here.
 

2013-08-15T06:00:04+00:00August 15th, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on New Pennsylvania Health Law Project Newsletter

MAAC Meets

The Medical Assistance Advisory Committee that works with the Pennsylvania’s Department of Public Welfare met recently in Harrisburg.
Among the subjects discussed during the meeting were the state’s recently passed budget, the Medical Assistance program, the prospects for Medicaid expansion, and more.
Read the official state file note summarizing the meeting hereHarrisburg, PA capital building.

2013-08-07T06:00:18+00:00August 7th, 2013|Meetings and notices, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on MAAC Meets

Tackling Medicaid “Super-Users”

All Pennsylvania safety-net hospitals have them:  a relatively small number of Medicaid patients who are constantly in need of care.
Five percent of all Medicaid beneficiaries account for more than half of all Medicaid expenditures.  The challenges such patients pose are legitimate:  many have multiple chronic conditions.
How best to serve these patients?  The Center for Medicaid and CHIP Services has been looking into this problem and the Center for Medicare and Medicaid Innovation and the Robert Wood Johnson Foundation have been underwriting demonstration programs designed to find better ways to care for these patients.
Read more about the problem and these models, and find a direct link to a Center for Medicaid and CHIP Services advisory bulletin on the subject, hereDoctor listening to patient on the Fierce Healthcare web site.

2013-08-01T06:00:23+00:00August 1st, 2013|Uncategorized|Comments Off on Tackling Medicaid “Super-Users”
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