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SNAPShots

Will PA Expand Medicaid Program?

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 articlePennsylvania State Keystone.

2012-11-15T06:00:12+00:00November 15th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off on Will PA Expand Medicaid Program?

Post-Election Diagnosis for Health Care

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.

2012-11-09T10:42:28+00:00November 9th, 2012|Health care reform|Comments Off on Post-Election Diagnosis for Health Care

Philadelphia Hospitals Hoping for Medicaid Expansion

Hospitals in the greater Philadelphia want the state to expand its Medicaid program as envisioned in the Affordable Care Act, the Philadelphia Business Journal reports.
According to a spokesman for the Delaware Valley Healthcare Council, Philadelphia-area hospitals are concerned that the state might not expand Medicaid eligibility.  That expansion, mandated by the 2010 health care reform law, was made optional earlier this year by a Supreme Court decision.
Read more about why Philadelphia-area hospitals – many of which are safety-net hospitals – are eager for the state to embrace the reform law’s Medicaid eligibility expansion in this Philadelphia Business Journal article.

2012-10-22T06:00:32+00:00October 22nd, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off on Philadelphia Hospitals Hoping for Medicaid Expansion

Medicare DSH Cuts Loom for PA Safety-Net Hospitals

Safety-net hospitals across the country will soon lose important funding that helps them care for many of their low-income and uninsured patients:  their Medicare disproportionate share hospital payments (Medicare DSH).
Come 2014, the Affordable Care Act mandates a significant cut in hospitals’ Medicare DSH payments.  The underlying rationale for this cut is that once the health care reform law’s individual insurance mandate takes effect and states begin greatly expanding Medicaid eligibility (a reform law mandate made optional by this year’s Supreme Court decision), hospitals will have fewer such patients and less need for supplemental DSH funding.
But as a Kaiser Health News article points out, hospital officials are concerned that the funding will phase out before the expanded insurance phases in, leaving them with fewer resources to care for their low-income, still-uninsured patients.
Pennsylvania’s safety-net hospitals, which care for large numbers of low-income and uninsured patients, figure to suffer considerably under such circumstances.
Learn more about the phase-down of Medicare DSH payments and the challenges hospitals will face in its wake in this Kaiser Health News articleHospital.

2012-10-17T06:00:13+00:00October 17th, 2012|Health care reform|Comments Off on Medicare DSH Cuts Loom for PA Safety-Net Hospitals

Physician Reluctance Threatens Medicaid Expansion in PA

If Pennsylvania moves ahead and expands Medicaid eligibility as envisioned in the Affordable Care Act, the ability of newly enrolled recipients to obtain medical care may be jeopardized by the reluctance of some physicians to take on more Medicaid patients.
According to a recent article in the journal Health Affairs, 68 percent of the state’s doctors are currently accepting new Medicaid patients.  Those who are not cite low reimbursement rates and already-high patient loads among the reasons they are not accepting new Medicaid patients.
Pennsylvania Governor Tom Corbett has not revealed whether he intends to expand Medicaid eligibility in the state and is not expected to do so until after the November election.  The mandatory Medicaid expansion, part of the 2010 health care reform law, was ruled unconstitutional by the U.S. Supreme Court, leaving expansion decisions to the individual states.
The Pennsylvania Department of Health says that 94 percent of rural doctors and 84 percent of the state’s urban doctors currently care for Medicaid patients.
Read more about the situation in Pennsylvania today and its implications for Medicaid expansion in this Pittsburgh Post-Gazette article.

2012-09-11T06:00:28+00:00September 11th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off on Physician Reluctance Threatens Medicaid Expansion in PA

“Medicaid Works,” Foundation Declares

Medicaid improves access to care and saves lives and deserves to be expanded in the manner envisioned in the Affordable Care Act, according to a new blog entry on the web site of the health care-focused Commonwealth Fund.
According to the blog commentary, Medicaid “fulfills the two main purposes of health insurance – ensuring access to needed care and providing adequate financial protection from burdensome medical expenses.”  It also cites research that “confirms that expanding Medicaid not only improves access to care and financial protection of vulnerable individuals and families, but actually saves lives.”
In addition, the blog suggests that Medicaid recipients have only slightly greater cost-related access-to-care problems than individuals with private insurance.
The Safety-Net Association of Pennsylvania (SNAP) and the state’s private safety-net hospitals have eagerly anticipated the expansion of Medicaid eligibility mandated by the Affordable Care Act.  In the wake of the Supreme Court decision ruling the expansion mandate unconstitutional, these safety-net hospitals now await for Governor Corbett’s decision on whether Pennsylvania will move ahead with that Medicaid expansion.
The title of this commentary is “Medicaid Works:  Public Program Continues to Provide Access to Care and Financial Protection for Society’s Most Vulnerable,” and it can be found here, on the Commonwealth Fund’s web site.

DPW Secretary Shares Views on Medicaid Program

In an extensive interview with the Central Penn Business Journal, Pennsylvania Department of Public Welfare Secretary Gary Alexander shared his views on the state’s Medicaid program, the changes he would like to see, and the challenges the state faces in the immediate future.
Among the issues Alexander addressed are his desire to have greater flexibility to operate the state’s Medical Assistance program; the state’s prospects for expanding Medicaid eligibility as called for in the Affordable Care Act; his concern that greater access will increase rather than decrease uncompensated care and emergency room use; his interest in greater transparency for health care costs and quality; and his fight against fraud, waste, and abuse.
Read the complete Central Penn Business Journal interview with Secretary Alexander here.

2012-08-21T06:00:48+00:00August 21st, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off on DPW Secretary Shares Views on Medicaid Program

Hospitals Worry About Lost DSH Money

Hospitals across the country are worried about what will happen come 2014, when the Affordable Care Act’s individual insurance mandate and Medicaid expansion take effect and they lose funds they currently receive from the federal government to help with the cost of caring for their low-income and uninsured patients.
Hospitals that care for large numbers of such patients receive what are known as disproportionate share hospital payments, commonly referred to as “DSH,” from both Medicare and Medicaid.  Under the 2009 health care reform law, however, those payments will be reduced drastically in anticipation of a significant decline in the number of uninsured Americans.
The leaders of these hospitals, however, believe that even the individual insurance mandate and Medicaid expansion will still leave them with many uninsured patients to treat, including illegal residents and those who decline to buy insurance despite the insurance mandate.
Historically, DSH funds have been vital to the financial health of Pennsylvania’s safety-net hospitals.
Read more about this situation, and the challenges hospitals believe they will face as a result, in this New York Times article.

2012-08-01T06:00:12+00:00August 1st, 2012|Health care reform|Comments Off on Hospitals Worry About Lost DSH Money

Court Affirms Reform Law, Changes Medicaid Provision

The Supreme Court has upheld the constitutionality of the 2009 Affordable Care Act – including the much-disputed mandate that everyone obtain health insurance.
The court’s only disagreement with the reform law was with its provision requiring states to expand Medicaid eligibility as a future condition of obtaining federal Medicaid matching funds.  The court ruled that expanding Medicaid eligibility should be optional and that states that choose not to expand their Medicaid programs would still receive the federal matching funds to which they have always been entitled.
In the wake of this decision, SNAP is very concerned about the interplay between the loss of the mandated Medicaid expansion and the Affordable Care Act’s requirement that Medicare DSH and Medicaid DSH payments be cut significantly in the coming years.  Those cuts were predicated on the Medicaid expansion adding as many as 20 million people to the ranks of the insured, which was expected to provide additional revenue to hospitals that would help offset a reduction in their Medicare DSH and Medicaid DSH revenue.
For now, all eyes will be on Pennsylvania state officials as they decide what to do in light of the greatly enhanced federal matching funds still available for states that choose to expand Medicaid eligibility.

2012-06-28T15:19:30+00:00June 28th, 2012|Health care reform, Medicaid supplemental payments, Pennsylvania Medicaid policy|Comments Off on Court Affirms Reform Law, Changes Medicaid Provision

If the Affordable Care Act Survives Legal Challenges…

$2 billion in extra costs over the first five years.  750,000 new recipients.
These are some of the changes that can be expected in Pennsylvania’s Medicaid program if the Medicaid expansion component of the Affordable Care Act is left standing after the Supreme Court rules on the legal challenge to the landmark health care reform legislation.
The online publication PA Independent takes a look at the implications of Medicaid expansion for Pennsylvania:  implications for the state’s finances, for potential beneficiaries, and for public health.  Read the article here.

2012-06-26T06:00:27+00:00June 26th, 2012|Health care reform, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off on If the Affordable Care Act Survives Legal Challenges…
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