Affordable Care Act Archives - Page 13 of 15 - Safety-Net Association of Pennsylvania

Enough Docs to Go Around?

With nine million people expected to enroll in Medicaid in the coming year, questions are arising about whether there will be enough physicians to serve them.
Across the country there has long been a shortage of physicians, and especially specialists, willing to serve Medicaid patients because of how poorly most state Medicaid programs pay those doctors. Now, with more people than ever expected to become insured by Medicaid, it is not clear whether the existing physician pool will be able to serve them very effectively.
The Affordable Care Act anticipated this problem and included a two-year increase in Medicaid payments to physicians, a move designed to raise Medicaid rates to the same level as those paid by Medicare. But states have been slow to make these payments, which were expected to begin last January, and physicians recognize that this will only be a temporary raise. As a result, fewer physicians than expected have agreed to serve Medicaid patients.
Whether this might pose a problem for Pennsylvania and its safety-net hospitals could depend on whether Governor Tom Corbett’s “Healthy Pennsylvania” proposal is fully implemented and the state expands Medicaid enrollment through the private health insurance market. One of the selling points of the Healthy Pennsylvania proposal has been that working through private insurers, rather than Medicaid managed care organizations or the state itself, should result in better payments for health care providers, thereby making those providers more willing to serve Medicaid patients.
See this New York Times article for a look at these and other questions related to the upcoming Medicaid expansion and the ability of the medical community to meet an unprecedented demand for care.

PA Safety Net Admin2013-12-03T06:00:13+00:00December 3rd, 2013|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off

Enrolling Homeless in Medicaid Poses Challenges, Offers Hope

Enrolling the homeless in Medicaid poses numerous logistical challenges for government, providers, and caregivers but also offers the prospect of improving the lives of those who gain access to care.
Many low-income, homeless adults will be eligible for Medicaid for the first time in states that expand Medicaid eligibility under the Affordable Care Act, but enrolling them in the program can be difficult: they can be hard to find, hard to convince to apply, and hard to enroll because they lack such basics as a mailing address and telephone number.
Yet bringing health care to such individuals could greatly improve their lives and perhaps help address their homelessness by ending the financial stresses that resulted in homelessness or improving their health to the point where they qualify for housing services.
While Pennsylvania still has not expanded its Medicaid program, it now appears to be on a cautious path toward doing so in the near future. If it does, enrolling the homeless in Medicaid also offers the prospect of the state’s safety-net hospitals receiving Medicaid reimbursement for the care they provide to such patients, typically through their emergency departments.
Learn more about the challenges of enrolling the homeless and Medicaid and the benefits of Medicaid eligibility for the homeless in this New York Times article.

PA Safety Net Admin2013-11-26T06:00:25+00:00November 26th, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

Safety-Net Hospitals Bear Brunt of Medicare Penalties

Hospitals that serve the largest proportion of low-income patients are suffering the greatest financial penalties under Medicare’s value-based purchasing program.
Collectively, hospitals that serve the most low-income patients are seeing their Medicare payments reduced 0.09 percent during year two of the Medicare program while hospitals that serve the fewest low-income patients have seen their Medicare payments rise 0.06 percent, according to a new study by a Harvard School of Public Health professor.
Medicare’s value-based purchasing program, mandated by the Affordable Care Act, bases penalties and bonuses on 24 quality measures.
In Pennsylvania, 45 percent of the state’s hospitals received bonuses while 53 percent were penalized; both figures are the same as the national averages. The average bonus for Pennsylvania hospitals was 0.24 percent – the national average – while the average penalty was 0.20 percent, slightly lower than the national average of 0.26 percent.
The author of the study suspects that the performance of safety-net hospitals may be suffering from the manner in which their patients are responding to the patient satisfaction survey that is one of the determining factors in evaluating hospital performance.
For a closer look at the study and its findings, see this Kaiser Health News report.

PA Safety Net Admin2013-11-22T06:00:26+00:00November 22nd, 2013|Affordable Care Act, Health care reform|Comments Off

400,000 Fall Into PA Insurance Gap

400,000 Pennsylvanians currently fall into a gap between eligibility for the state’s Medicaid program and qualifying for health insurance subsidies through the state’s health insurance marketplace.
Under the Affordable Care Act, states were to expand eligibility for their Medicaid programs while the federal government would provide partial subsidies for low-income people who remained ineligible for Medicaid but were unlikely to be able to afford health insurance without such assistance.
But when the Supreme Court made Medicaid expansion optional for states, many people fell into a new insurance gap that was not anticipated when the 2010 reform law was written. Approximately half of the 50 states have expanded their Medicaid programs as the law expected, but in the half that did not, millions remain in this gap, earning too much money to qualify for Medicaid but not enough to be able to afford health insurance.
Among those millions are 400,000 Pennsylvanians because the commonwealth has not decided to move forward and expand its Medicaid program. Currently, state officials are exploring such expansion through a new “Healthy Pennsylvania” initiative and are negotiating possible terms for expansion with the federal government.
Learn more about Pennsylvania’s insurance gap, who is in it, why it exists, and why it is a candidate to disappear sometime in the future in this Philadelphia Inquirer article.

PA Safety Net Admin2013-11-20T06:00:19+00:00November 20th, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy, Uncategorized|Comments Off

ACA Drives Rise in Medicaid Enrollment

While some aspects of implementation of the Affordable Care Act continue to struggle with technical problems, one aspect is moving ahead effectively: enrollment in Medicaid is on the rise.
More than 400,000 newly eligible people in just ten states have enrolled in Medicaid since October 1. The ten states are among the 25 that have decided to expand their Medicaid programs in accordance with provisions of the federal health care reform law. Other states either have chosen not to expand their programs or are still undecided about expansion.
Pennsylvania is one of the states that has not expanded its Medicaid program but state officials are currently negotiating a possible expansion with the federal government. The Safety-Net Association of Pennsylvania supports such an expansion.
The Congressional Budget Office projects that nine million people will join the Medicaid ranks through Affordable Care Act expansion provisions in the coming year.
For more about the increase in Medicaid enrollment and how it is being accomplished despite some of the reform law’s early technical problems, see this Washington Post article.

PA Safety Net Admin2013-11-13T06:00:03+00:00November 13th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

A Look at the Corbett Medicaid Proposal

Pennsylvania Governor Tom Corbett’s “Healthy Pennsylvania” proposal calls for an expansion of the state’s Medicaid program as envisioned when the Affordable Care Act was passed three years ago.
Or does it?
Is it Medicaid expansion or is it something entirely different? In the article “Pennsylvania Governor Talks Up Plan To Expand Medicaid His Way,” Kaiser Health News takes a look at how elected officials, advocates, and others are viewing the recent Healthy Pennsylvania proposal. Find the article here.

PA Safety Net Admin2013-10-29T06:00:07+00:00October 29th, 2013|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off

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.

PA Safety Net Admin2013-10-16T10:08:33+00:00October 16th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

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.
The 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.

PA Safety Net Admin2013-10-01T06:00:02+00:00October 1st, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

The Underlying Rationale For “Healthy Pennsylvania”

Reducing costs.
Sustainability.
Simplification.
These 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.

PA Safety Net Admin2013-09-30T06:00:47+00:00September 30th, 2013|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off

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.

PA Safety Net Admin2013-09-27T06:00:53+00:00September 27th, 2013|Affordable Care Act|Comments Off

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