Affordable Care Act Archives - Page 7 of 16 - Safety-Net Association of Pennsylvania

PA Submits Medicaid Plan to Feds

Yesterday the Corbett administration submitted a waiver application to the federal government requesting permission to expand the state’s Medicaid program as described in its “Healthy Pennsylvania” proposal.
The Pennsylvania proposal seeks to vary from the approach taken by most states expanding their Medicaid programs in accordance with the Affordable Care Act by directing the expansion population into private health insurance plans.
A draft waiver application, released in December, was the subject of public hearings throughout the state. The Safety-Net Association of Pennsylvania (SNAP) testified at one of those hearings and also submitted detailed written comments about the proposal; both can be found here.
The state’s waiver application, the December draft application, a summary of the application, and the written and oral comments about the proposed application submitted by interested parties can be found here, on the Pennsylvania Department of Public Welfare’s web site. Learn more about the proposal’s submission to the federal government and where it goes from here in this Ellwood City Ledger article and the reaction of some elected officials to the submission here.
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PA Safety Net Admin2014-02-20T06:00:20+00:00February 20th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

New Approaches to Serving Dual Eligibles Set to Launch

Provisions in the Affordable Care Act that encourage states to take new approaches to serving their dually eligible residents – low-income seniors eligible for both Medicare and Medicaid – will soon translate into new state programs.
Massachusetts has already launched such an initiative, a new California program will begin in May, and 17 additional states are scheduled to begin new efforts later this year and next.
New federal policies encourage state Medicaid programs to work with Medicare in service to their dually eligible population, with the states and Medicare sharing in the savings they produce. Currently, dually eligible patients constitute 15 percent of the Medicaid population but account for 40 percent of Medicaid’s costs and 20 percent of the Medicare population but 30 percent of Medicare’s costs.
Eighteen percent of Pennsylvania’s Medicaid population is dually eligible. The state is not among those with new dual eligibles programs preparing to launch.
How are states tackling this challenge? Learn more in this Stateline report.

PA Safety Net Admin2014-02-18T06:00:56+00:00February 18th, 2014|Pennsylvania Medicaid policy|Comments Off

First Round of Data on PA Health Insurance Sign-Ups

123,681 Pennsylvanians signed up for health insurance through the federally facilitated marketplace between October 1 and February 1, according to a new report from the U.S. Department of Health and Human Services.
Among Pennsylvanians who enrolled in new health insurance plans, 79 percent were eligible for financial assistance with their premiums and 56 percent are female while 44 percent are male.
Among those who enrolled in insurance plans through the marketplace, 26 percent are between the ages of 18 and 34; 15 percent are between the ages of 35 and 44; 22 percent are between 45 and 54; and 36 percent are between 55 and 64.
In all, the marketplace evaluated 286,926 Pennsylvanians for eligibility for subsidized insurance, Medicaid, and the Children’s Health Insurance Program (CHIP). 29,365 were found eligible for Medicaid or CHIP.
Learn more about the first round of Pennsylvanians who signed up for health insurance, including the types of plans they selected and more, in this Department of Health and Human Services report.

PA Safety Net Admin2014-02-14T06:00:26+00:00February 14th, 2014|Affordable Care Act|Comments Off

PA Labeled “State to Watch” for Medicaid in 2014

The Corbett administration’s “Healthy Pennsylvania” Medicaid expansion proposal has earned the commonwealth recognition from the Washington Post’s “Wonkblog” feature as one of four “states to watch” in 2014.
The Post notes that “How much flexibility the Obama administration grants to Pennsylvania could be influential to the other states, still sitting on the sidelines, waiting to decide whether to expand their own Medicaid programs in the future.”
The other states to watch cited by the Post are Arkansas, approved to use federal Medicaid money to purchase private insurance for its Medicaid population but now in jeopardy of backing out of its own expansion plan; Virginia, where a serious effort is expected to expand the state’s Medicaid program; and Utah, whose governor has declared that doing nothing “is off the table.”
Read the Washington Post article “The four most important states to watch on Obamacare’s Medicaid expansion” here.

PA Safety Net Admin2014-01-30T14:16:11+00:00January 30th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

The Path to PA’s Medicaid Waiver

The Corbett administration’s Healthy Pennsylvania proposal seeks to go where only two states have gone so far with their Affordable Care Act-enabled Medicaid expansion: the unconventional route.
While many of the states that have chosen to expand their Medicaid programs under the terms of the Affordable Care Act did so by embracing those terms, others are viewing Medicaid expansion as an opportunity to pursue wholesale changes in how they serve their low-income residents.
Arkansas and Iowa have already received federal waivers – exemptions from selected aspects of existing Medicaid law– to expand their Medicaid programs. Under these waivers, the states operate demonstration programs to test the effectiveness of their variations on ordinary Medicaid practices.
Pennsylvania seeks to follow in their path, and Virginia, New Hampshire, Indiana, and possibly a few other states are expected to do the same in 2014.
Learn more about the path to obtaining such a waiver and the challenges Pennsylvania may face along the way in this Stateline report.

PA Safety Net Admin2014-01-28T06:00:55+00:00January 28th, 2014|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off

CMS Offers Advice on Managing Expected Upsurge in ER Visits

With Medicaid enrollment rising because of eligibility changes introduced through the Affordable Care Act, hospital emergency rooms expect to see an increase in the number of emergency room visits as new Medicaid enrollees seek care for long-neglected health problems.
In anticipation of this rise in ER visits, the Centers for Medicare & Medicaid Services (CMS) has issued an informational bulletin with suggestions for hospitals on how to manage the expected increase in ER utilization.
Among CMS’s suggestions are for hospitals to broaden access to primary care services (because much of the increased utilization will be because the newly insured still do not know where to turn for care); focus on helping especially frequent ER visits find more appropriate sources of care; and target the needs of people with behavioral health problems.
This influx of new ER patients will pose a challenge for Pennsylvania’s safety-net hospitals because even though the state has not expanded its Medicaid eligibility criteria as provided for in the Affordable Care Act, other reform-related measures should result in some increase in the state’s Medicaid population.
To learn more about CMS’s recommendations for addressing this ER challenge, including some of the legal and reimbursement-related challenges this will pose, see the CMS informational bulletin “Reducing Nonurgent Use of Emergency Departments and Improving Appropriate Care in Appropriate Settings.”

PA Safety Net Admin2014-01-24T06:00:53+00:00January 24th, 2014|Affordable Care Act|Comments Off

Providers Receive Expanded Authority to Extend Presumptive Medicaid Eligibility

While hospitals and providers in 33 states have long enjoyed the ability to extend presumptive eligibility for Medicaid to children or pregnant women, that authority is now being extended in some states to any adults whose income appears likely to fall below 138 percent of the federal poverty level.
The extension of this authority comes via the Affordable Care Act, which also offers states the option of expanding Medicaid eligibility for their residents. Individual states decide whether to extend this authority, which is typically wielded by hospitals, schools, clinics, other providers of care to the Medicaid and CHIP population, Head Start programs, and others.
This policy could benefit many Pennsylvania safety-net hospitals because they serve much higher proportions of low-income patients than the average hospital. Currently, 52 acute-care hospitals in the state are authorized to determine presumptive eligibility.
To learn more about changes in extending presumptive eligibility to low-income patients, see the policy brief “Hospital Presumptive Eligibility” from the Robert Wood Johnson Foundation and the publication Health Affairs.

PA Safety Net Admin2014-01-16T12:31:52+00:00January 16th, 2014|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Pennsylvania, the Uninsured, and the Affordable Care Act

How will the Affordable Care Act expand health insurance coverage in Pennsylvania?
How many Pennsylvanians might be eligible for subsidized insurance under the reform law?
These questions and others are addressed in the new Kaiser Family Foundation report “How Will the Uninsured in Pennsylvania Fare Under the Affordable Care Act?” Find that report here.

PA Safety Net Admin2014-01-13T06:00:54+00:00January 13th, 2014|Affordable Care Act, Health care reform|Comments Off

Concern About Churn

State government and health insurers are worried about a process called “churning” – people moving back and forth between Medicaid and private insurers as their income changes. With more people now qualified for Medicaid, observers believe that as many as nine million people may move back and forth between Medicaid and private insurance in 2014.
In the past, people whose income rose enough to lose their Medicaid eligibility often could not afford private insurance and joined the ranks of the uninsured. Now, some will be eligible for subsidies that may enable them to purchase health insurance on their own. People who move back and forth between insurers, however, may be at risk of gaps in coverage and loss of continuity of care.
Churn may be especially prevalent in the lower-income communities served by Pennsylvania’s safety-net hospitals.
How does churn work and what are the states doing to anticipate and address it? Learn more in this Washington Post article.

PA Safety Net Admin2014-01-08T06:00:58+00:00January 8th, 2014|Affordable Care Act|Comments Off

Supply of Doctors to be Tested by the Newly Insured

With various aspects of the Affordable Care Act helping millions of people obtain health insurance, it remains to be seen whether there will be enough doctors to care for them.
In particular, primary care physicians, dentists, and mental health professionals could be in short supply, leaving some newly insured patients struggling to find providers to help them exercise their new access to care. Many parts of the country, in fact, have been certified by the federal government as health professional shortage areas. Pennsylvania has many health professional shortage areas and federally designated medically underserved areas.
Learn more about the potential shortage of physicians, where that problem arises, and what is being done about it in this Stateline report .

PA Safety Net Admin2014-01-07T06:00:49+00:00January 7th, 2014|Affordable Care Act|Comments Off

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