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Gap in Reform Law Could Leave Many Low-Income People Uninsured

When the Supreme Court gave states discretion over whether to expand their Medicaid programs under the Affordable Care Act, it unintentionally created a gap in potential coverage options for many low-income people that may leave many of those people without affordable health insurance.
According to a new report from the Commonwealth Fund, the 2010 reform law anticipated that everyone with incomes below 133 percent of the federal poverty level would be covered by Medicaid.  Individuals and families with incomes between 133 percent and 399 percent of the federal poverty level could use new federal subsidies to help purchase private health insurance.
In states that are not expanding their Medicaid programs, people with incomes between 133 percent and 399 percent of the federal poverty level will still be able to take advantage of federal premium subsidies.  People with incomes less than 133 percent of the federal poverty level but who do not qualify for their state’s Medicaid program – qualification criteria vary from state to state – will not be eligible for the same subsidies as many who earn more than them because the reform law assumed that all such individuals would be covered by Medicaid.
According to the Commonwealth Fund, this unanticipated gap in the reform law means that as many as 42 percent of people who suffer from periodic or chronic lack of insurance and who live in states that are not expanding their Medicaid programs will not benefit in any way from Affordable Care Act insurance reforms.
Pennsylvania is one of the states in which this problem will occur because the state is not expanding its Medicaid program.  It almost certainly will require Pennsylvania’s safety-net hospitals to provide more uncompensated care than originally expected when the reform law was enacted.
Read more about the unintended consequences of the Supreme Court’s decision and the choice by some states not to expand their Medicaid programs in In States’ Hands:  How the Decision to Expand Medicaid Will Affect the Most Financially Vulnerable Americans, a new report from the Commonwealth Fund.

2013-09-09T06:00:22+00:00September 9th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on Gap in Reform Law Could Leave Many Low-Income People Uninsured

Medicaid Expansion to Ease Hospitals’ Uncompensated Care But Not in PA

Hospitals in states that expand their Medicaid programs under provisions of the Affordable Care Act should see a reduction in their uncompensated care once people begin applying for Medicaid benefits.
That will not be happening in Pennsylvania, however, because the state is not expanding eligibility for its Medicaid program.
In states that do expand their programs, hospitals will continue to lose money serving Medicaid patients because Medicaid payments seldom cover the cost of the services hospitals provide.  Demand for Medicaid services will grow in these states, moreover, as more people become eligible for benefits and some who have not had regular access to care for years begin to use their new benefits to address long-standing medical problems.
Recent published reports suggest that the Corbett administration is working on an expansion plan, to be negotiated with the federal government, and that this plan may be revealed to the public this fall.
Michigan became the most recent state to decide to take advantage of the Affordable Care Act and expand its Medicaid program.  For a look at how Medicaid expansion will affect hospitals in that state, see this Detroit Free Press articleHospital building.
 

2013-09-04T13:40:02+00:00September 4th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on Medicaid Expansion to Ease Hospitals’ Uncompensated Care But Not in PA

PA Inching Closer to Medicaid Expansion

Pennsylvania state officials are working on a proposal to expand Medicaid eligibility in the state as provided for in the Affordable Care Act.
But newly eligible Pennsylvanians would not participate in the state’s current Medicaid program.
Speaking to a rotary club in York, Department of Public Welfare Secretary Bev Mackereth told her audience that because the state lacks confidence in the willingness of the federal government to continue funding care for new Medicaid enrollees, the state is developing a plan to present different Medicaid options to newly eligible people.
State officials continue to negotiate the terms of such a program with the federal government and anticipate submitting their proposal to the federal government in the near future.  If approved, they do not anticipate launching such an initiative until at least January of 2015.
Read more about the state’s plans in this Calkins Media report.

2013-08-30T06:00:24+00:00August 30th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on PA Inching Closer to Medicaid Expansion

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has released its latest newsletter.
Features include articles about the state budget and the possible expansion of Medicaid eligibility in Pennsylvania; upcoming changes facing CHIP and PA Fair Care participants; an upcoming study on serving dual eligibles in the state; a new state Medicaid waiver application; and more.
Find the latest Pennsylvania Health Law Project newsletter here.
 

2013-08-15T06:00:04+00:00August 15th, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on New Pennsylvania Health Law Project Newsletter

MAAC Meets

The Medical Assistance Advisory Committee that works with the Pennsylvania’s Department of Public Welfare met recently in Harrisburg.
Among the subjects discussed during the meeting were the state’s recently passed budget, the Medical Assistance program, the prospects for Medicaid expansion, and more.
Read the official state file note summarizing the meeting hereHarrisburg, PA capital building.

2013-08-07T06:00:18+00:00August 7th, 2013|Meetings and notices, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on MAAC Meets

The Implications of Rejecting Medicaid Expansion

Twenty-one states have decided not to expand their Medicaid programs under the Affordable Care Act and another six states remain undecided.
How will these decisions affect these states and their residents?  How many people who might have become eligible for Medicaid will remain uninsured?  How much federal Medicaid revenue will these states forgo?  How will these decisions affect hospitals’ uncompensated care costs?  How might payments to hospitals be affected?
Pennsylvania is one of the six states where Medicaid expansion is still being considered, and the report includes specific projections for the commonwealth.  The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state.
A new study from the Urban Institute attempts to quantify the answers to these and other questions.  Find “The Cost of Not Expanding Medicaid” here, on the web site of the Kaiser Commission on Medicaid and the Uninsured.

2013-07-25T06:00:48+00:00July 25th, 2013|Health care reform, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on The Implications of Rejecting Medicaid Expansion

SNAP Comments on Observation Rate Proposal

The Safety-Net Association of Pennsylvania has submitted a formal comment letter to the state’s Department of Public Welfare in response to the department’s expressed interest in establishing an observation rate in the state’s Medical Assistance fee-for-service program.
DPW expressed this interest in a June 29 Pennsylvania Bulletin notice.
SNAP supports the creation of an observation rate, and in its letter it outlines how it believes DPW should go about developing a rate that is fair to hospitals.
Safety-net hospitals have a special interest in this issue because observation rate candidates enter hospitals through their emergency rooms and safety-net hospitals typically have among the busiest emergency rooms in the communities they serve.
Read SNAP’s observation rate comment letter hereSafety-Net Association of Pennsylvania logo.

2013-07-23T16:12:30+00:00July 23rd, 2013|Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on SNAP Comments on Observation Rate Proposal

Closer Scrutiny Needed for Medicaid Managed Care?

With Medicaid expansion about to begin in many states and managed care expected to be a major tool in that expansion, advocates are suggesting that states need to do a better job of monitoring the performance of the managed care plans that serve their Medicaid population.
Currently, according to advocates, different states monitor their Medicaid managed care plans for different aspects of their performance and some states do a better job than others.  With relatively few federal standards, state-to-state comparisons either are difficult or impossible.
Thirty-six states and the District of Columbia have at least some Medicaid patients enrolled in managed care plans, and together, those plans receive about one out of every four dollars that the states and the federal government spend on Medicaid.
With nearly all of the state’s Medicaid recipients now in managed care plans, this issue is of special interest to Pennsylvania’s safety-net hospitals.
Read more about the issue, the challenges, and why this issue is now receiving attention in this Kaiser Health News report.
 

2013-07-10T06:00:18+00:00July 10th, 2013|Pennsylvania Medicaid policy|Comments Off on Closer Scrutiny Needed for Medicaid Managed Care?
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