In an op-ed piece in Sunday’s Philadelphia Inquirer, Pennsylvania Governor Tom Corbett presented the reasons he decided to let the federal government develop the state’s health insurance exchange – a key part of the Affordable Care Act – instead of having his own administration develop the exchange.
Read Governor Corbett’s op-ed piece here
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States must opt into the Affordable Care Act’s Medicaid expansion or opt out, the federal government has informed the nation’s governors. They may not implement a partial expansion.
That was the message conveyed to governors by Kathleen Sebelius, Secretary of the U.S. Department of Health and Services (HHS).
The Medicaid expansion, made mandatory in the 2010 health care reform law, has been the subject of much debate since the Supreme Court ruled the mandate unconstitutional in June and instead left the decision on whether to expand to the individual states. Some governors have already declared that their states will expand their Medicaid programs, some have announced that they will not, and many still have not decided.
Pennsylvania is among the states that have not yet announced whether they will expand their Medicaid programs, although Governor Tom Corbett has signaled that he is reluctant to incur the additional costs that expansion would involve. The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion.
Read more about this latest decision from HHS in this Washington Post article and read an FAQ that HHS sent to governors regarding both Medicaid expansion and the operation of health insurance exchanges here.
The time for states to decide whether they will expand their Medicaid programs in accordance with the Affordable Care Act is fast approaching.
With the Medicaid expansion due to begin in 2014, thirteen states seem likely to opt out, 14 appear ready to expand, and the rest are still on the fence.
Among the major concerns of states still deciding are the cost of expansion and their concern that the federal government, currently scheduled to assume almost all of the cost of expansion, may at some point decide to shift more of expansion’s costs to state governments.
Pennsylvania is among the undecided states, but comments in recent months by Governor Corbett suggest that he is leaning against Medicaid expansion in the commonwealth. The Safety-Net Association of Pennsylvania (SNAP) supports that expansion.
Read more about the deliberations taking place in state capitals across the country, and the questions with which elected officials are wrestling, in this Washington Post article
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Pennsylvania cannot decide whether to operate its own health insurance exchange or allow the federal government to operate an exchange for the state until it gets more information from the federal government about the regulations governing exchanges, how much they will cost to operate, and what a partnership with the federal government might look like.
That’s the message Pennsylvania Governor Tom Corbett conveyed last week.
Health insurance exchanges are among the most important components of the Affordable Care Act. States have until December 14 to inform the federal government whether they will operate their own exchange and Pennsylvania is one of ten states that still had not made this decision.
Read more about Governor Corbett’s thoughts on health insurance exchanges and the additional information he seeks before deciding in this PA Independent article
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Lured by billions of dollars in federal money, governors resisting the Affordable Care Act’s Medicaid expansion option will eventually give in and expand their states’ Medicaid programs as provided for in the 2010 health care reform law.
Or so predict several experts who participated in a recent health policy forum in Washington, D.C.
Some may not do so right away, the experts warned, but the financial benefits of expanding their Medicaid programs and capturing billions in federal Medicaid matching money will eventually become too much to resist.
Pennsylvania is among many states still not committed to Medicaid expansion. In recent public statements, Governor Tom Corbett has suggested that the state cannot afford to spend the additional money expansion would require.
Read more about the policy forum and the experts’ predictions in this Politico article.
Expanding Pennsylvania’s Medicaid program as envisioned in the Affordable Care Act would cost Pennsylvania $1.96 billion over the ten years beginning in FY 2013, according to a new report released by the Kaiser Family Foundation.
While that price tag may seem steep, it is only 1.4 percent more than the additional money the state would spend if it declines to expand its Medicaid program as the 2010 health care reform law envisioned.
Expanding Medicaid would spur a 52 percent increase in the number of Pennsylvanians with health insurance. Without the Medicaid expansion, the number of insured would rise 28.9 percent because of other Affordable Care Act provisions.
Pennsylvania’s safety-net hospitals would benefit greatly from the expansion of Medicaid in the state. Many of the uninsured patients they currently serve would almost certainly become eligible for Medicaid under such an expansion.
Learn more about how Medicaid expansion would affect Pennsylvania in this Central Penn Business Journal article. The Kaiser Family Foundation study on which it is based can be found here.
Without explicitly ruling out expansion of the state’s Medicaid program, which is now an optional part of the federal health care reform law, Pennsylvania Governor Tom Corbett has hinted broadly that the state may not be prepared to spend the additional money such an expansion would necessitate.
“I don’t think there’s any way we can absorb this,” the governor told the Pennsylvania Press Club, speaking of the Medicaid expansion that is a major part of the 2010 Affordable Care Act.
Read more about what those costs would be, and the challenges the state would face in expanding its Medicaid program, in this PA Independent article.
With President Obama re-elected and Congress unlikely to repeal the Affordable Care Act, Pennsylvania officials now face a major decision: will they expand the state’s Medicaid programs as the law originally intended?
The original health care reform law made that expansion mandatory, but earlier this year, the Supreme Court left the expansion decision to individual states. While some governors have already declared their intention to expand their Medicaid programs and others have announced that they will not, Pennsylvania Governor Tom Corbett has not yet announced a decision.
Why would the state choose to expand its Medicaid program, considering that it will end up costing taxpayers more money? On the other hand, why would it choose to leave billions of federal dollars on the table?
Because they serve so many low-income, uninsured patients who might benefit from an easing of Medicaid eligibility criteria, Pennsylvania’s private safety-net hospitals have a major stake in this decision.
Read more about the decision now facing the Corbett administration in this CQ HealthBeat article presented by the Commonwealth Fund. For a closer look at the Pennsylvania perspective, read this PA Independent article
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Pennsylvania must inform the federal government by November 16 whether it intends to create a state health insurance exchange as envisioned in the Affordable Care Act.
If the state decides not to create its own exchange, the federal government will create an exchange for it.
While some observers believe the state has intentionally not invested a great deal of time and effort in developing the exchange – or spent any of the $33 million the federal government gave it for this purpose – state officials insist that they are moving ahead with the work but have been hampered by a lack of direction from the federal government. In August, state insurance commissioner Michael Consedine wrote to U.S. Health and Human Services secretary Kathleen Sebelius seeking such direction but has not yet received a response.
Other states are in the same situation as Philadelphia – so many states, in fact, that many observers believe the federal government will extend the deadline for states to declare their intentions.Read more about this situation and what it means for Pennsylvania in this Allentown Morning Call article.
While President Obama’s re-election probably spells the end of talk of repealing the Affordable Care Act, many questions remain about how – and how completely – the health care reform law passed in 2010 will be implemented.
In the days following the election, observers are asking these and other questions.
In the article “Federal Deficit Talks Could Impact Obama’s Moves on Health Law,” Kaiser Health News speculates about the future of some of the more controversial and expensive aspects of the Affordable Care Act, including creation of the Independent Payment Advisory Board; the extensive insurance subsidies for which many Americans will be eligible; the future of the medical device tax; and the law’s provisions that limit the degree to which insurers can charge higher rates for older people.
The Stateline web site looks at the decisions ahead for state governments in the article “Obama Win Means Big Health Care Decisions for States.” Many governors still have not declared whether their state will expand their Medicaid programs – a move required by the Affordable Care Act but made optional by the Supreme Court in a June 2012 decision.
The first issue that will be addressed, though, is state decisions on whether to create their own health insurance exchanges, a key part of the reform law, or let the federal government create those exchanges for them. States are required to inform the federal government of their intentions by November 16, although it now appears they will be given more time. Pennsylvania is among the states that have not yet declared their intentions.
Meanwhile, looming over the health care industry is the prospect of sequestration, part of last year’s deficit reduction compromise, that leaves Medicaid untouched but will require a cut of two percent in all Medicare payments beginning on January 1 unless Congress acts to prevent these cuts. Read more about this in an article from The Hill titled “Sequester Would Cut $11 Billion from Medicare.”
These and other issues are of particular importance to Pennsylvania’s safety-net hospitals because of the especially large numbers of low-income and publicly insured patients they serve.