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PA Renews CHIP

Pennsylvania has extended its Children’s Health Insurance Program (CHIP) through the end of 2015.
The law renewing the program, which provides health insurance to all children who needs it, also eliminates the six-month waiting period for eligibility for services.
The state also intends to increase its outreach efforts in an attempt to reverse a recent decline in program enrollment.
Currently, CHIP serves 188,000 children in the state.
Read more about the CHIP renewal and the program itself in this Philadelphia Inquirer article.
 

2013-10-21T06:00:42+00:00October 21st, 2013|Uncategorized|Comments Off on PA Renews CHIP

Millions to Fall Into Coverage Gap

More than five million adult Americans will fall into the Affordable Care Act’s Supreme Court-created coverage gap in states that have chosen not to expand their Medicaid programs.
In those 26 states, adults whom the reform law intended to be covered by Medicaid will still earn too much money to qualify for Medicaid yet also will fall below the income level needed to qualify for Affordable Care Act health insurance subsidies.
This gap was created when the Supreme Court made the reform law-mandated Medicaid expansion optional for individual states, and so far, 26 states have chosen not to expand their Medicaid programs.  The result, according to a new issue brief from the Kaiser Commission on Medicaid and the Uninsured, is that 5.2 million low-income adults whom the law intended to enroll in Medicaid will remain uninsured.
More than 280,000 of these people reside in Pennsylvania, which has not yet expanded its Medicaid program.  Many will continue to be served by the state’s private safety-net hospitals, which will not be paid for the care they provide.
To learn more about these people and why they will remain uninsured, read the study “The Coverage Gap:  Uninsured Poor Adults in States That Do Not Expand Medicaid.”  Find the study here, on the web site of the Kaiser Family Foundation.
 

2013-10-16T10:08:33+00:00October 16th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on Millions to Fall Into Coverage Gap

DPW Reaches Out to Stakeholders Over Tobacco $ Loss

Pennsylvania Department of Public Welfare Secretary Beverly Mackereth has sent the following message to health care providers and other stakeholders that will be affected by the state’s loss of $180 million in national tobacco settlement money as a result of a recent arbitrary decision.

October 2, 2013

I am reaching out to you, our valued stakeholder, to provide you with information about the potential impact of the recent tobacco master settlement agreement (MSA) decision. Please understand this legal action and the potential next steps are in no way a reflection of the quality of your work or actions as a partner with the Department of Public Welfare (DPW).  This decision stems back to circumstances that occurred in 2003.

As you may be aware, the Pennsylvania Attorney General’s office recently notified the Governor’s Budget Office that the state’s annual share of the tobacco MSA will be reduced by an estimated $180 million, or 60 percent of the state’s base tobacco payment, as a result of a decision by an arbitration panel to address claims from 2003.

While this decision has immediate impacts to Pennsylvania’s health and human services programs, the Corbett Administration is committed to maintaining direct services and mandatory healthcare programs.  I would like to reassure you that we are working diligently to ensure services will continue without interruption for all Pennsylvanians.

The reduction will occur in the state’s April 2014 MSA payment, which supports spending in the current fiscal year. This has forced the state to freeze discretionary funding from the MSA. As of now the only DPW program affected will be uncompensated care payments to hospitals.

Please be assured, this course of action was not arrived at lightly.  Immediate action is necessary in the face of such a dramatic decrease in revenues due to the MSA decision. Moving forward, the Attorney General’s Office is preparing an appeal of the decision.

The attached press release provides additional information regarding this issue. I appreciate your time and understanding as we work together on this issue.

Sincerely,
Beverly Mackereth, Secretary
Department of Public Welfare

The loss of uncompensated care payments will pose a major challenge to the state’s safety-net hospitals, which are the primary providers of care to the uninsured in Pennsylvania and the primary recipients of these funds.
Go here for the press release cited above.

2013-10-04T06:00:00+00:00October 4th, 2013|Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on DPW Reaches Out to Stakeholders Over Tobacco $ Loss

Tobacco Money Loss Imperils Hospital Uncompensated Care Payments

Pennsylvania’s loss of $180 million from the national tobacco master settlement agreement could affect the state’s Tobacco Uncompensated Care program, which provides supplemental funding to hospitals that provide significant amounts of uncompensated care.
The $180 million cut represents 60 percent of the state’s overall tobacco revenue.
According to a news release from the governor’s budget office,

The reduction will occur in the state’s April 2014 MSA [master settlement agreement] payment, which supports spending in the current year’s budget.  This is forcing the state to freeze discretionary funding from the MSA, which will reduce funds for health research (Commonwealth Universal Research Enhancement [CURE] grants), Life Sciences Greenhouses, uncompensated care to hospitals, and discretionary funds related to tobacco prevention and cessation programs.

To learn more about the funding loss and its implications, see the news release “Administration Receives Notification on Impacts from Tobacco Master Settlement Agreement Arbitration Panel Decision” from the governor’s budget office.

2013-10-03T09:22:36+00:00October 3rd, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on Tobacco Money Loss Imperils Hospital Uncompensated Care Payments

Arkansas Medicaid Plan Gains Federal Approval; Harbinger for PA?

A bid by the state of Arkansas to expand access to Medicaid by enabling newly eligible recipients to use federal Medicaid funds to purchase health insurance has been approved by the federal Centers for Medicare & Medicaid Services (CMS).
While the Arkansas Medicaid proposal is not identical to Governor Corbett’s recently released “Healthy Pennsylvania” plan, the two share a key common component:  the use of federal Medicaid funds to enable newly eligible recipients to purchase private insurance through new health insurance exchanges that open for business on October 1.
Bookshelf with law booksThe path to federal approval for Healthy Pennsylvania remains challenging, but the Arkansas ruling appears to be a clear sign that the federal government is receptive to one of the key components of Governor Corbett’s proposal.
To learn more about the Arkansas Medicaid plan and the federal decision to approve it, see this San Francisco Chronicle article.

2013-10-01T06:00:02+00:00October 1st, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off on Arkansas Medicaid Plan Gains Federal Approval; Harbinger for PA?

The Underlying Rationale For “Healthy Pennsylvania”

Reducing costs.
Sustainability.
Simplification.
Harrisburg, PA capital buildingThese are among the reasons that members of the Corbett administration offer for why the Medicaid expansion components of the governor’s Healthy Pennsylvania proposal are structured as they are.
The online publication PA Independent talked to a number of administration officials about why they have chosen the proposed path to health care reform in the state.  Read what they had to say in the article “PA looks to reform Medicaid, stave off cost increases” here, on the PA Independent web site.

2013-09-30T06:00:47+00:00September 30th, 2013|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off on The Underlying Rationale For “Healthy Pennsylvania”

CMS Proposes Basic Health Program

The Centers for Medicare & Medicaid Services (CMS) has unveiled a proposal to establish what it is calling a “Basic Health Program” that gives states “the option to establish a health benefits coverage program for low-income individuals who would otherwise be eligible to purchase coverage through the Health Insurance Marketplace.”
The program, established in the Affordable Care Act, is designed for people who do not qualify for Medicaid or CHIP and whose incomes are between 133 percent and 200 percent of the federal poverty level.  Legal residents who are non-citizens whose incomes are below 133 percent of the federal poverty level also qualify.  The federal government is picking up 95 percent of the cost of this program.
A new proposed regulation addresses who is eligible, how enrollment works, enrollee financial responsibilities, the program’s basic benefits, and more.
Such a program could prove beneficial to many low-income residents of communities served by Pennsylvania’s safety-net hospitals.
Read about the new Basic Health Program in this CMS fact sheet, which also includes a link to the entire proposed regulation.

 

2013-09-27T06:00:53+00:00September 27th, 2013|Affordable Care Act|Comments Off on CMS Proposes Basic Health Program

First Peek at PA’s Health Insurance Exchange

A new report from the U.S. Department of Health and Human Services offers a first look at the health insurance choices to be available to residents of 36 states, including Pennsylvania.
According to the report, premiums before subsidies – not yet released publicly – will average about 16 percent lower than Congressional Budget Office projections.
Across the state, Pennsylvanians will average a choice of 56 insurance plans.  The selection varies by region, with 42 choices for residents of the Philadelphia area and 36 for those who reside in Pittsburgh.Health Benefits Claim Form
The health insurance exchanges are one of the main features of the Affordable Care Act.
Rate information for the individual plans will be released next Tuesday, but monthly premiums for Pennsylvanians reportedly will be lower than the average for the 36 states for which information is available.
For more on the selection of plans, see this Pittsburgh Post-Gazette article.  For information about rates, including a chart that shows examples, see this report in the Central Penn Business Journal.
 

2013-09-26T06:00:02+00:00September 26th, 2013|Affordable Care Act|Comments Off on First Peek at PA’s Health Insurance Exchange

ACA Insurance Subsidies for 900,000 Pennsylvanians?

As many as 900,000 Pennsylvanians could be eligible on October 1 for the insurance premium subsidies that are a major part of the Affordable Care Act, according to the advocacy group Families USA.
Learn more about the subsidies, who qualifies for them, and how they work in this WHYY Newsworks article.

2013-09-24T06:00:22+00:00September 24th, 2013|Affordable Care Act|Comments Off on ACA Insurance Subsidies for 900,000 Pennsylvanians?

CMS Finalizes Medicaid DSH Cuts

The Centers for Medicare & Medicaid Services (CMS) has issued a final Medicaid disproportionate share (Medicaid DSH) regulation that cuts federal spending on Medicaid DSH $500 million in FY 2014 and $600 million in FY 2015.
The Medicaid DSH cuts were mandated by the Affordable Care Act in anticipation of every state expanding its Medicaid program.  The reform law’s Medicaid expansion mandate was later made optional by a Supreme Court ruling.
Medicaid DSH cuts will hurt all Pennsylvania safety-net hospitals, and the Safety-Net Association of Pennsylvania (SNAP) has conveyed its opposition to the cuts to CMS and also has asked members of Pennsylvania’s congressional delegation to support current legislation to delay the implementation of both Medicaid DSH and Medicare DSH cuts for two years.
While the Affordable Care Act calls for Medicaid DSH cuts through 2020, the new regulation covers only two years.  CMS has indicated that it will review its reduction methodology for future years.
Read more about the Medicaid DSH cut, why it was made, the objections to it, and future Medicaid DSH cuts in this CQ Healthbeat article presented by the Commonwealth Fund.

2013-09-20T06:00:29+00:00September 20th, 2013|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off on CMS Finalizes Medicaid DSH Cuts
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