Affordable Care Act Archives - Page 6 of 15 - Safety-Net Association of Pennsylvania

Pennsylvania Health Law Project Releases Monthly Newsletter

The Pennsylvania Health Law Project has published the July edition of Health Law News, its monthly newsletter.
Included in this edition are articles about the continued expansion of Pennsylvania’s Medicaid program; the next steps in Pennsylvania’s managed long-term services and supports (MLTSS) initiative; the state’s selection of its benchmark essential health benefits insurance plan for 2017; and about how the state will phase out its current AIDS waiver while continuing to serve those covered by the waiver.
Find the latest edition of Health Law News here.

PA Safety Net Admin2015-08-05T06:00:29+00:00August 5th, 2015|Affordable Care Act, long-term care, Pennsylvania Medicaid policy|Comments Off

The Challenges Medicaid Faces

As it celebrates is fiftieth birthday, Medicaid now covers 70 million Americans at a cost of $500 billion a year. As the program continues to grow amid the expansion facilitated by the Affordable Care Act, Kaiser Health News has identified the five biggest challenges the program faces today:

controlling costs
getting all states to expand income eligibility
providing better oversight of managed care
ensuring access to doctors and dentists
meeting the growing demand for long-term care

For a closer look at these challenges and what they entail, see this Kaiser Health News article.

PA Safety Net Admin2015-07-29T06:00:55+00:00July 29th, 2015|Affordable Care Act|Comments Off

439,000 Added to PA Medicaid Rolls

150,000 Pennsylvanians have enrolled in Medicaid since the Wolf administration officially launched its HealthChoices expansion on April 27.
Added to the 289,000 who enrolled during the Corbett administration’s Healthy Pennsylvania program, that means about 439,000 Pennsylvanians have obtained Medicaid coverage since the state expanded its Medicaid program as authorized by the 2010 federal health care reform law.
To learn more about the latest Medicaid enrollments, their financial impact on the state, and how the HealthChoices expansion works, see this Wolf administration news release.

PA Safety Net Admin2015-07-27T06:00:19+00:00July 27th, 2015|Affordable Care Act, HealthChoices PA, Healthy PA|Comments Off

PA Won’t Develop Exchange After All

Immediately after the Supreme Court verdict in the case of King v. Burwell was handed down, the Wolf administration announced that it will no longer seek to create a Pennsylvania health insurance exchange.
In a news release, Governor Wolf explained that

I took steps to protect Pennsylvania’s consumers by putting in place a contingency in the event the Supreme Court ruled people are not eligible for subsidies, but I am pleased to say that we will no longer need to rely on this plan.

See the news release here.

PA Safety Net Admin2015-06-30T06:00:14+00:00June 30th, 2015|Affordable Care Act|Comments Off

Feds Approve Plan for PA to Establish Insurance Exchange

The U.S. Department of Health and Human Services (HHS) has approved a request by Pennsylvania Governor Tom Wolf for permission for his state to develop a state-based marketplace through which to offer health insurance to Pennsylvanians as provided for in the Affordable Care Act.
Currently, Pennsylvanians seeking health insurance use the federal exchange. The constitutionality of the use of that exchange is currently being weighed by the Supreme Court and the Wolf administration’s desire to create a state exchange is widely considered an attempt to avoid a crisis should the court rule against the federal government in the case of King v. Burwell. A ruling in that case is expected in the very near future.
Go here to see the letter from HHS Secretary Sylvia Burwell to Pennsylvania Governor Tom Wolf authorizing the state to move ahead with development of its state-based exchange.

PA Safety Net Admin2015-06-18T06:00:53+00:00June 18th, 2015|Affordable Care Act, Health care reform|Comments Off

Variations on Medicaid Expansion

While most states that have taken advantage of the Affordable Care Act’s Medicaid expansion have simply expanded their existing Medicaid programs to incorporate the newly eligible, six states have taken a different path, pursuing what are known as section 1115 waivers – waivers of formal Medicaid requirements – to expand their Medicaid programs in different ways.
Typically, those different ways involve coverage modeled on private sector insurance practices, including requiring the newly eligible to choose from among approved managed care plans on the private market; the elimination of some traditional Medicaid benefits; the imposition of work requirements and higher premiums; and more.
In the new report Medicaid Expansion, The Private Option and Personal Responsibility Requirements: The Use of Section 1115 Waivers to Implement Medicaid Expansion Under the ACA, the Urban Institute takes a close look at the six states that have taken this alternative path; among the states reviewed is Pennsylvania and its now-discarded “Healthy Pennsylvania” Medicaid expansion plan. In addition, the Commonwealth Fund has published “The Promise and Pitfalls of Alternative State Approaches to Medicaid Reform,” a commentary on the efforts of the states that have followed this alternative path.

PA Safety Net Admin2015-06-17T06:00:02+00:00June 17th, 2015|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off

PA Seeks to Establish Health Insurance Marketplace

In anticipation of a possible Supreme Court decision that could jeopardize the health insurance of an estimated 382,000 Pennsylvanians, the Wolf administration has applied to the federal government to establish a state-based health insurance marketplace.
The Supreme Court is currently weighing a challenge to the use by some states of the federal health insurance marketplace and the contention of litigants that the Affordable Care Act specifies that insurance subsidies would only be available through state-based exchanges. If the court rules against the federal government, the insurance of residents of states that did not establish their own exchanges and who instead obtained their insurance and federal subsidies through the federal exchange will be in jeopardy.
The move by the Wolf administration is a contingency plan and does not commit the state to developing its own exchange.
For further information about the state’s application to establish a health insurance exchange, see this Wolf administration news release.

PA Safety Net Admin2015-06-05T06:00:42+00:00June 5th, 2015|Affordable Care Act, Health care reform|Comments Off

But Does Coverage Mean Access?

More than 12 million people have joined the Medicaid rolls in the U.S. since the Affordable Care Act’s voluntary expansion of Medicaid eligibility began in January of 2014.
Historically, however, many Medicaid patients have had a difficult time finding doctors willing to serve them because in many states, Medicaid payments are so low that doctors choose not to participate in the program.
Is that still the case today? What challenges do Medicaid patients face when they need medical care?
In a new article titled “You’ve Got Medicaid – Why Can’t You See the Doctor?”, U.S. News & World Report takes a look at this issue. Find its report here.

PA Safety Net Admin2015-06-03T06:00:53+00:00June 3rd, 2015|Affordable Care Act|Comments Off

Feds Release First SIM Grant Performance Evaluation

In 2013, the federal Center for Medicare & Medicaid Innovation (CMMI) awarded its first State Innovation Model grants. Now, the agency has released its first evaluations of the performance of grant recipients.
State Innovation Model or SIM grants, established under the Affordable Care Act, were created to support the development of innovative payment and care delivery models that reduce state health care spending while preserving or improving the quality of care. The law set aside $10 billion to support the program, which generally provides financial and technical support to states for the development and testing of multi-payer payment and delivery models.
Now, CMMI has published its first evaluations of the performance of states awarded SIM grants. See those evaluations here and here; the latter document includes an extensive description of Pennsylvania’s SIM planning activities.

PA Safety Net Admin2015-06-02T11:33:28+00:00June 2nd, 2015|Affordable Care Act|Comments Off

Underinsurance Remains a Problem

Twenty-three percent of American adults are uninsured, according to a new survey by the Commonwealth Fund.
Among them, 14 million had deductibles that exceeded five percent of their income while another 24 million had deductibles that fell below that threshold but had out-of-pocket health care costs – deductibles, co-insurance, co-payments, and out-of-network payments – that exceeded ten percent of their income.
The figures are for 2012 and reflected no change since 2010 but were nearly twice those found in 2003.
In addition, the survey found that the proportion of the insured with high-deductible plans has more than tripled, from three percent to 11 percent, since 2003. This is believed to reflect the proliferation of high-deductible plans in recent years – a proliferation that has increased with implementation of the Affordable Care Act and the many high-deductible plans offered through the federal exchange and state exchanges. This survey, however, did not distinguish between pre- and post-Affordable Care Act insurance policies.
Another category of the uninsured is those with income less than 200 percent of the federal poverty level whose out-of-pocket health care costs are greater than five percent of their income. Such individuals can pose a special challenge to safety-net hospitals because they often are unable to pay their co-pays, deductibles, and some of their medical costs.
For a closer look at the numbers, who is underinsured, the role of high-deductible plans in being underinsured, the effect of being underinsured on gaining access to care and addressing health problems, and more, see The Problem of Underinsurance and How Rising Deductibles Will Make it Worse, an issue brief summarizing the Commonwealth Fund survey.

PA Safety Net Admin2015-05-26T06:00:35+00:00May 26th, 2015|Affordable Care Act|Comments Off

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