The Pennsylvania Health Law Project has published the March 2013 edition of Health Law PA News, its monthly newsletter.Features this month include articles about the governor’s proposed FY 2014, prospects for Medicaid expansion, coming Affordable Care Act changes, the final expansion of HealthChoices, and more.
Find a link to the complete newsletter here
, on the web site of the Pennsylvania Health Law Project.
Still rejecting expansion of the state’s Medicaid program as envisioned under the Affordable Care Act, Pennsylvania Tom Corbett has indicated that he may be interested in following the lead of a few other states in attempting to use federal Medicaid expansion money to purchase private health insurance for newly eligible Medicaid recipients.
This news comes in the aftermath of the governor’s Washington, D.C. visit with Health and Human Services Secretary Kathleen Sebelius during which the two officials discussed the governor’s reluctance to incur the future cost increases that he believes the state will face under Medicaid expansion.
Recently, the governors of Arkansas, Ohio, and several other states have expressed interest in purchasing private insurance for new Medicaid recipients instead of expanding their states’ traditional Medicaid programs.
Read more about Governor Corbett’s meeting with Secretary Sebelius and the possibility that the state’s closed door to the question of Medicaid expansion is now slightly ajar in this Philadelphia Inquirer article.
A new study suggests that expanding Medicaid eligibility in Pennsylvania would create as many as 39,000 new jobs over the next seven years and generate enough new revenue to pay the state’s share of the expansion’s costs.
Or so says a new study by RAND Health.
According to the study, Medicaid expansion under the terms established by the Affordable Care Act would reduce Pennsylvania’s uninsured rate from the current 12.7 percent to 4.8 percent in 2016, spur $20 billion in economic growth by 2020, and generate more new tax revenue than the state would need to spend to pay its share of expansion’s cost once the federal share of expansion drops from 100 percent to 90 percent.
The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state.
Read more about the RAND Health report, and find a link to the study, in this Central Penn Business Journal article.
In their desire to persuade states to expand their Medicaid programs as called for in the Affordable Care Act, federal officials are now suggesting that states could use new federal Medicaid funds to enable Medicaid-eligible people to purchase private insurance.
Even though this was not envisioned in the health reform law, the prospect of making greater use of the private sector appears to be appealing to many Republican governors who have otherwise been reluctant to commit their states to expanding their Medicaid programs.
Pennsylvania has no current plans to expand Medicaid eligibility, although there appears to be growing interest in doing so throughout the state. Expansion would add approximately 500,000 people to the state’s Medicaid rolls, many of whom would be served by safety-net hospitals. The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the commonwealth.
Read more about how this idea came about, why many states find it appealing, how it would work, and what the potential challenges are in this New York Times article.
Immigrants to the U.S. – legal and not – pose a special challenge in the health care environment of the future.
Legal immigrants will not be able to benefit from many of the Affordable Care Act’s provisions until they have resided in the U.S. for five years while undocumented residents will not benefit from the reform law’s Medicaid expansion at all. Meanwhile, many of these individuals will continue to turn to health care providers, and especially to hospitals, when they are sick or injured.
But is this is a problem? And if it is, how great a problem is it? How many such individuals are there?
The Robert Wood Johnson Foundation has attempted to answer that question in a new report titled “State Estimates of the Low-Income Uninsured Not Eligible for the ACA Medicaid Expansion.” Among the report’s findings, it notes that
Safety-net health care providers are likely to continue to be key providers for this population after health reform, and the need for safety-net care will not be spread evenly across states. The capacity of safety-net providers to fill this gap will need to be assessed. While all states will need to develop strategies for meeting the health care needs of these adults, the challenges will be particularly difficult for safety-net providers in states with large numbers of immigrants who will not be eligible for Medicaid.
According to the report, about two percent of Pennsylvania’s non-elderly adults are unauthorized or recent legal immigrants; three percent of the state’s low-income, non-elderly adults are unauthorized or recent legal immigrants; and six percent of the state’s low-income, uninsured, non-elderly adults are unauthorized or recent legal immigrants.
Many of these individuals will undoubtedly turn to Pennsylvania’s safety-net hospitals for medical services.
Find the report here
.
Safety-net and other hospitals will suffer financially when Affordable Care Act-mandated cuts in Medicare disproportionate share hospital payments (Medicare DSH) and Medicaid DSH payments begin taking effect in FY 2014.
So concludes Moody’s, the bond-rating agency.
The losses will be especially harmful to hospitals in states that do not expand their Medicaid programs and to safety-net hospitals, Moody’s believes.
Currently, Pennsylvania has no plans to expand its Medicaid program as envisioned by the Affordable Care Act.
Hospitals face other specific challenges as well as a result of these cuts.
Read more about Moody’s assessment of the impact of future Medicare DSH and Medicaid DSH cuts in this report
in Becker’s Hospital Review.
Medicaid expansion in Pennsylvania could help compensate hospitals for the care they are currently providing to uninsured patients.
And enhanced Medicaid payments made possible under the Affordable Care Act also could help hospitals with their Medicaid shortfalls: the difference between what Pennsylvania pays hospitals for the Medicaid services they provide and the actual cost of those services.
So hospital executives around the state recently told the Johnstown Tribune-Democrat.
To learn more about how selected hospital executives view Medicaid expansion and why the Corbett administration has been reluctant so far to go ahead with that expansion, read the article “Small hospitals could gain from expansion” in this Johnstown Tribune-Democrat article.
The Philadelphia Inquirer has published an editorial calling on Pennsylvania Governor Tom Corbett to expand eligibility for the state’s Medical Assistance program as envisioned in the Affordable Care Act.
Read that editorial here
.
Expanding Medicaid as called for in the Affordable Care Act would extend health insurance to nearly 700,000 currently uninsured Pennsylvanians and create more than 41,000 new jobs in the state in 2016 according to a new report.
Medicaid expansion also would result in $3.3 billion in new health care spending in Pennsylvania and generate $5.1 billion in new economic activity in 2016.
These are among the conclusions presented ind “Pennsylvania’s Economy Will Benefit From Expanding Medicaid,” a new report issued jointly by the Pennsylvania Health Access Network and the national advocacy group Families USA.
Learn more about the report and its analysis and find a link to the entire report here, on the web site of the Pennsylvania Health Access Network.
Pennsylvania Governor Tom Corbett has at least temporarily closed the door to the Medicaid expansion envisioned in the Affordable Care Act.
On the same day that he presented his proposed state budget for the 2014 fiscal year, Mr. Corbett wrote to U.S. Health and Human Services Secretary Kathleen Sebelius, explaining that
At this time, and without serious reforms, it would be financially unsustainable for Pennsylvania taxpayers, and I cannot recommend a dramatic Medicaid expansion.
See Governor Corbett’s letter to Secretary Sebelius here.
At the same time, however, the governor did not rule out the possibility of a change of heart sometime in the future. His proposed budget document explains that
At this time, analysis continues on the financial sustainability related to potential expansion of the Medicaid program. The Department of Public Welfare continues to have a dialogue with the U.S. Department of Health and Human Services (HHS) in an effort to obtain clarification and answers on a number of issues, including whether essential reforms of the Medicaid program can be accomplished to improve the health of our citizens and the effectiveness of the program. The department is currently reviewing the recently released proposed regulations on eligibility and benefits from HHS. While due diligence continues, no decision has been made at this time.
The administration intends to engage in an informed dialogue with the public and the legislature on whether expansion of the Medicaid program is prudent, affordable and the right choice for the commonwealth. When a final decision is made, it will be done in consultation with the Legislature and it may require modifications to be made and accounted for in the budget.
The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state.