Saturday, August 23, 2014
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Corbett's Medicaid Plan is Too Little Too Late

Last Friday, Arkansas received approval from the federal government to expand its Medicaid program in a manner that is different from the one envisioned by the Affordable Care Act. Last month, Governor Corbett announced “Healthy PA,” a plan he claims mirrors the Arkansas proposal. Both plans give premium assistance to most individuals making up to133% of the federal poverty level (FPL) to purchase private insurance in the new health reform exchanges. Persons deemed “medically fragile” would still receive traditional Medicaid.

Corbett’s Medicaid Plan is Too Little Too Late

Last Friday, Arkansas received approval from the federal government to expand its Medicaid program in a manner that is different from the one envisioned by the Affordable Care Act. Last month, Governor Corbett announced “Healthy PA,” a plan he claims mirrors the Arkansas proposal. Both plans give premium assistance to most individuals making up to133% of the federal poverty level (FPL) to purchase private insurance in the new health reform exchanges. Persons deemed “medically fragile” would still receive traditional Medicaid.

The Arkansas approval may seem like a positive sign for the Corbett plan, but there are key differences between the proposals that may prevent the Governor’s plan from being approved.

The Corbett proposal requires most unemployed Medicaid beneficiaries to conduct computer-based work searches or participate in job training. Because the overwhelming majority of them are already working, the federal government has said it will reject the work search requirement as a waste of time and money.

The Corbett plan also requires most Medicaid beneficiaries to pay premiums of up to $25 a month for an individual and $35 for a family.  However, the federal Medicaid law does not allow premiums to be charged to individuals who fall below 100% of the federal poverty line.

This proposal would make significant changes to the current Medicaid program which will likely result in cuts to current beneficiaries. Medicaid plays a vital role in protecting Pennsylvania’s most vulnerable citizens. The majority (73%) of Medicaid spending in Pennsylvania goes to nursing home care for seniors.

It is encouraging that the Governor has acknowledged that working families deserve healthcare. However, his plan leaves many questions unanswered. He has compared his proposal to the Arkansas plan, but that system does not include work search requirements or premiums. And it was developed in time to begin when the Medicaid expansion was originally envisioned to take effect in January 2014. The longer Pennsylvania delays, the more it will cost the state’s taxpayers in lost federal funds and the longer needy Pennsylvanians will go without care.

Failing to expand Medicaid by January 1, 2014 will cost Pennsylvania $522 million in 2014 alone, and it could threaten as many as 40,000 potential new jobs. It will also leave hundreds of thousands of our neighbors without access to health care. Pennsylvania cannot afford to delay any longer. We need a Medicaid expansion that can take effect as soon as possible.

About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on Inquirer.com and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Donald Schwarz, MD, MPH Deputy Mayor for Health & Opportunity and Health Commissioner for the City of Philadelphia
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
Krystyna Dereszowska A third-year law student concentrating in health at Drexel
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