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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.

2014-01-28T06:00:55+00:00January 28th, 2014|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off on The Path to PA’s Medicaid Waiver

Healthy PA Hearings End

Public hearings on the Corbett administration’s “Healthy Pennsylvania” health care reform and Medicaid insurance expansion proposal ended last week with a hearing in Harrisburg.
Forty people testified at the final hearing, including SNAP president Michael Chirieleison; his oral testimony and SNAP’s more detailed written submission can be found here.
For a summary of the final hearing and a look at what might happen next according to Department of Public Welfare Secretary Beverly Mackereth, see this article on the web site of WITF, Harrisburg’s public television station.

2014-01-17T06:00:48+00:00January 17th, 2014|Healthy PA|Comments Off on Healthy PA Hearings End

SNAP Comments on Proposed Medicaid Waiver

The Safety-Net Association of Pennsylvania has submitted extensive comments to the Pennsylvania Department of Public Welfare regarding the state’s application for a section 1115 Medicaid waiver needed to enable the state to expand its Medicaid program through private market insurers.
The highlights of SNAP’s comments include its call for extending retroactive eligibility to those who obtain Medicaid coverage through the private market; easing proposed limits on benefits and penalties for non-payment of premiums; retaining the current supplemental Medicaid payments qualified hospitals receive; and pursuing greater investment in the health care infrastructure of communities with especially high proportions of low-income patients.
See SNAP’s complete written submission here.Safety-Net Association of Pennsylvania logo.

2014-01-14T11:47:11+00:00January 14th, 2014|Health care reform, Healthy PA, Medicaid supplemental payments, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on SNAP Comments on Proposed Medicaid Waiver

SNAP Testifies About Healthy Pennsylvania

The Safety-Net Association of Pennsylvania (SNAP) has weighed in on Governor Corbett’s Healthy Pennsylvania health care reform and insurance expansion proposal.
Testifying at a January 9 public hearing in Harrisburg, SNAP president Michael Chirieleison expressed general support for the Healthy Pennsylvania proposal and addressed four aspects of it that safety-net hospitals would like to see improved: Safety-Net Association of Pennsylvania logo

  •  extension of retroactive eligibility to the Medicaid expansion population;
  • including inpatient services provided to that same population as “Medicaid days” for the purpose of determining eligibility for supplemental Medicaid payments and other government programs;
  • reconsideration of proposed benefit limits and suspension of eligibility for non-payment of premiums; and
  • the addition of a Delivery System Reform Incentive Program or a similar program to support the development of health care infrastructure in communities with large numbers of low-income Pennsylvanians.

Read SNAP’s testimony here.

2014-01-09T14:14:05+00:00January 9th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off on SNAP Testifies About Healthy Pennsylvania

Healthy PA Road Show Visits Philadelphia

The process of taking public input on Governor Corbett’s Healthy Pennsylvania Medicaid expansion and health care reform proposal continued last Friday with a hearing in Philadelphia.
Among those who testified before Department of Public Welfare Secretary Beverly Mackereth and other state officials were representatives of Project Home, the Cover the Commonwealth Campaign, the Disability Rights Network of Pennsylvania, the Health Federation of Philadelphia, the Pennsylvania Health Care Association, Jefferson Health System, and Mercy Health System, the newest member of the Safety-Net Association of Pennsylvania (SNAP).
Read more about the hearing and the testimony offered in this Philadelphia Business Journal report.
The hearing was the third of six schedule sessions.  Hearings already have been held in Erie and Pittsburgh; a hearing is scheduled for today, January 6, in Scranton; and hearings also will be held on January 7 in Altoona and January 9 in Harrisburg.  SNAP president Michael Chirieleison will testify in Harrisburg and SNAP also will submit extensive written comments about the Healthy Pennsylvania proposal.

2014-01-06T06:00:49+00:00January 6th, 2014|Healthy PA, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on Healthy PA Road Show Visits Philadelphia

Healthy PA Testimony in Pittsburgh

Thirty people testified at a recent public hearing in Pittsburgh as the Pennsylvania Department of Public Welfare continued its tour of the state seeking input on Governor Corbett’s Healthy Pennsylvania proposal and its Medicaid expansion component.
Among those who testified were both supporters and critics of the plan.
To learn more about the views expressed during the three-hour public hearing, read reports from the Pittsburgh Tribune Review and Pittsburgh Post-Gazette.

2013-12-24T06:00:26+00:00December 24th, 2013|Pennsylvania Medicaid policy|Comments Off on Healthy PA Testimony in Pittsburgh

Iowa Approval Good Sign for PA?

Last week the federal government granted Iowa permission to expand its Medicaid program by enabling newly eligible residents to purchase state-approved, subsidized private health insurance.
Pennsylvania currently is planning to make a similar request, and Iowa now is the second state to be permitted to move forward in this manner.  Arkansas received permission for a similar approach to Medicaid expansion in September.
While there are differences between the approved Arkansas and Iowa programs and the approach embodied in the Corbett administration’s “Healthy Pennsylvania” proposal, the Iowa approval suggests a continued willingness of the federal government to consider private insurance market alternatives to Medicaid expansion.
Learn more about the approved Iowa plan in this Kaiser Health News report.

2013-12-17T06:00:07+00:00December 17th, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off on Iowa Approval Good Sign for PA?

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.

Enough Docs to Go Around?

With nine million people expected to enroll in Medicaid in the coming year, questions are arising about whether there will be enough physicians to serve them.
Across the country there has long been a shortage of physicians, and especially specialists, willing to serve Medicaid patients because of how poorly most state Medicaid programs pay those doctors.  Now, with more people than ever expected to become insured by Medicaid, it is not clear whether the existing physician pool will be able to serve them very effectively.
The Affordable Care Act anticipated this problem and included a two-year increase in Medicaid payments to physicians, a move designed to raise Medicaid rates to the same level as those paid by Medicare.  But states have been slow to make these payments, which were expected to begin last January, and physicians recognize that this will only be a temporary raise.  As a result, fewer physicians than expected have agreed to serve Medicaid patients.
Doctor listening to patientWhether this might pose a problem for Pennsylvania and its safety-net hospitals could depend on whether Governor Tom Corbett’s “Healthy Pennsylvania” proposal is fully implemented and the state expands Medicaid enrollment through the private health insurance market.  One of the selling points of the Healthy Pennsylvania proposal has been that working through private insurers, rather than Medicaid managed care organizations or the state itself, should result in better payments for health care providers, thereby making those providers more willing to serve Medicaid patients.
See this New York Times article for a look at these and other questions related to the upcoming Medicaid expansion and the ability of the medical community to meet an unprecedented demand for care.

2013-12-03T06:00:13+00:00December 3rd, 2013|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off on Enough Docs to Go Around?

A Look at the Corbett Medicaid Proposal

Pennsylvania Governor Tom Corbett’s “Healthy Pennsylvania” proposal calls for an expansion of the state’s Medicaid program as envisioned when the Affordable Care Act was passed three years ago.
Or does it?
Is it Medicaid expansion or is it something entirely different?  In the article “Pennsylvania Governor Talks Up Plan To Expand Medicaid His Way,” Kaiser Health News takes a look at how elected officials, advocates, and others are viewing the recent Healthy Pennsylvania proposal.  Find the article here.

2013-10-29T06:00:07+00:00October 29th, 2013|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off on A Look at the Corbett Medicaid Proposal
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