Health care reform Archives - Page 5 of 13 - Safety-Net Association of Pennsylvania

Delay in Switch From CHIP to Medicaid

The federal government is permitting Pennsylvania to delay shifting children currently enrolled in the state’s Children’s Health Insurance Program (CHIP) into Medicaid.
The state has objected to such a transition, which is mandated by the Affordable Care Act, and is in the process of attempting to negotiate a compromise with federal officials. Those federal officials have agreed to delay the required transition until they have an opportunity to review the state’s new proposal, which should be delivered later this week.
Learn more about this issue in this article in The (Cumberland County) Sentinel.

PA Safety Net Admin2013-12-10T06:00:51+00:00December 10th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

PA Seeks Federal OK for Medicaid Expansion

The Corbett administration is asking the federal government to authorize the expansion of the state’s Medicaid program to serve another 500,000 people.
Healthy Pennsylvania, the reform plan unveiled by the Corbett administration in September, calls for expanding eligibility for Medicaid as envisioned in the federal Affordable Care Act but providing coverage to newly eligible individuals through private insurers
Under the plan, most newly eligible recipients would select state-subsidized insurance through the federal health insurance marketplace and receive the same benefits as regular commercial customers.
Healthy Pennsylvania also calls for streamlined benefits packages, enrollee premiums, and a work search requirement.
The formal unveiling of the plan is linked to the state’s application to the federal government for a waiver from selected federal Medicaid requirements. While states routinely request such waivers, each waiver is subject to individual scrutiny and negotiation between the state and federal governments after a period of public comment at the state level.
To learn more about the Healthy Pennsylvania proposal, see this Philadelphia Inquirer article. The administration also has published a description of its proposed application for the federal waiver, including information about how interested parties may comment on the proposal, in the Pennsylvania Bulletin; that notice can be found here. The complete draft waiver application can be found here.

PA Safety Net Admin2013-12-06T10:48:35+00:00December 6th, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Uncategorized|Comments Off

Feds Find Temporary Way to Overcome Medicaid Enrollment Problem

The problems plaguing the beleaguered healthcare.gov web site continue to make it difficult for people to find new health insurance, but a new approach devised by the federal government will make it easier for Medicaid applicants to overcome this problem.
While the Centers for Medicare & Medicaid Services (CMS) was having trouble sending completed Medicaid and CHIP applications to the states, it continued sending them basic data from Medicaid and CHIP applications on a weekly basis primarily to help them gauge possible interest in Medicaid enrollment. Now, it is telling states they can use this limited data to enroll such individuals in their Medicaid programs without complete applications.
This process is expected to facilitate enrollment in states that have chosen to expand eligibility for their Medicaid programs. To date, Medicaid enrollment has been one of the brightest aspects of the troubled launch of the Affordable Care Act’s insurance expansion. While Pennsylvania is not expanding its Medicaid program at this time, the process could facilitate the enrollment of so-called woodwork applicants: people who are already eligible for Medicaid and never enrolled but have been drawn to do so by all of the attention the Medicaid expansion and Affordable Care Act have received.
To learn more about the CMS workaround to this problem, read this Kaiser Health News report or read the letter CMS sent to state Medicaid directors describing how this process will work.

PA Safety Net Admin2013-12-05T06:00:58+00:00December 5th, 2013|Affordable Care Act, Health care reform, 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

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

Reform Will Give Medicaid Population a New Look

Once the Affordable Care Act’s Medicaid expansion is implemented, the Medicaid population as a whole will be younger, whiter, healthier, and more male but also more likely to smoke and drink to excess than it is today.
That is the conclusion reached by in a new report published in the Annals of Family Medicine.
This means that spending per recipient may not be as great for new Medicaid recipients as it is for current beneficiaries and that a different patient population may need different approaches to addressing different health challenges.
Learn more about the study and its implications in the article “Potential Adult Medicaid Beneficiaries Under the Patient Protection and Affordable Care Act Compared With Current Adult Medicaid Beneficiaries, which can be found here , on the web site of the journal Annals of Family Medicine.

PA Safety Net Admin2013-09-13T06:00:10+00:00September 13th, 2013|Affordable Care Act, Health care reform|Comments Off

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