Medicaid expansion Archives - Page 3 of 8 - Safety-Net Association of Pennsylvania

Uncompensated Care Down in Medicaid Expansion States

Hospitals in states that chose to take advantage of the Affordable Care Act’s Medicaid expansion option are providing less charity care than hospitals in states that have not expanded their Medicaid programs.
So reports the Colorado Hospital Association after its survey of 465 hospitals in 30 states.
According to the survey, hospitals’ proportion of Medicaid patients increased in states that expanded their Medicaid programs and did not increase in states that did not expand their Medicaid program and uncompensated care fell in states that expanded their Medicaid programs but did not in other states.
Addressing the extent of these changes, the survey found that

The changes seen here are not only distinct, but also substantial. The Medicaid proportion of total charges increased over three percentage points to 18.8 percent in 2014 from 15.3 percent in 2013, representing a 29 percent growth in the volume of Medicaid charges. When compared to the first quarter of 2013, there was a 30 percent drop in average charity care per hospital across expansion states, to $1.9 million from $2.8 million. Similarly, total self-pay charges declined 25 percent in expansion states, bringing its proportion of total charges down to 3.1 percent from 4.7 percent. In contrast, the proportion of Medicare volume shows little variation through first quarter 2014.

Pennsylvania has not yet expanded its Medicaid program but is currently negotiating the terms of doing so with the federal government.
Find the complete Colorado Hospital Association report here.

PA Safety Net Admin2014-06-06T06:00:25+00:00June 6th, 2014|Affordable Care Act, Pennsylvania Medicaid policy|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

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:

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.

PA Safety Net Admin2014-01-09T14:14:05+00:00January 9th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|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

Medicaid Applications Flowing From DC to PA

Pennsylvania is now receiving Medicaid applications from the federal government’s health insurance marketplace website.
Improvements in the healthcare.gov web site have enabled the federal government to begin sending data about Medicaid-eligible applicants to a number of states, including Pennsylvania. Until now, the data had been promised but technical problems prevented the federal government from fulfilling that promise.
Read more about the process of transforming visitors to the healthcare.gov into Pennsylvania Medicaid applicants in this Reading Eagle article.

PA Safety Net Admin2013-12-26T06:00:04+00:00December 26th, 2013|Health care reform|Comments Off

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.

PA Safety Net Admin2013-12-17T06:00:07+00:00December 17th, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

400,000 Fall Into PA Insurance Gap

400,000 Pennsylvanians currently fall into a gap between eligibility for the state’s Medicaid program and qualifying for health insurance subsidies through the state’s health insurance marketplace.
Under the Affordable Care Act, states were to expand eligibility for their Medicaid programs while the federal government would provide partial subsidies for low-income people who remained ineligible for Medicaid but were unlikely to be able to afford health insurance without such assistance.
But when the Supreme Court made Medicaid expansion optional for states, many people fell into a new insurance gap that was not anticipated when the 2010 reform law was written. Approximately half of the 50 states have expanded their Medicaid programs as the law expected, but in the half that did not, millions remain in this gap, earning too much money to qualify for Medicaid but not enough to be able to afford health insurance.
Among those millions are 400,000 Pennsylvanians because the commonwealth has not decided to move forward and expand its Medicaid program. Currently, state officials are exploring such expansion through a new “Healthy Pennsylvania” initiative and are negotiating possible terms for expansion with the federal government.
Learn more about Pennsylvania’s insurance gap, who is in it, why it exists, and why it is a candidate to disappear sometime in the future in this Philadelphia Inquirer article.

PA Safety Net Admin2013-11-20T06:00:19+00:00November 20th, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy, Uncategorized|Comments Off

ACA Drives Rise in Medicaid Enrollment

While some aspects of implementation of the Affordable Care Act continue to struggle with technical problems, one aspect is moving ahead effectively: enrollment in Medicaid is on the rise.
More than 400,000 newly eligible people in just ten states have enrolled in Medicaid since October 1. The ten states are among the 25 that have decided to expand their Medicaid programs in accordance with provisions of the federal health care reform law. Other states either have chosen not to expand their programs or are still undecided about expansion.
Pennsylvania is one of the states that has not expanded its Medicaid program but state officials are currently negotiating a possible expansion with the federal government. The Safety-Net Association of Pennsylvania supports such an expansion.
The Congressional Budget Office projects that nine million people will join the Medicaid ranks through Affordable Care Act expansion provisions in the coming year.
For more about the increase in Medicaid enrollment and how it is being accomplished despite some of the reform law’s early technical problems, see this Washington Post article.

PA Safety Net Admin2013-11-13T06:00:03+00:00November 13th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

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