Falling through the cracks in Pennsylvania

It's tempting to get lost in the politics of Gov. Corbett's proposed plan to expand Medicaid (see here for scathing commentary, here for gentler one) or the wonky "weeds" of the plan itself (see here for excellent analysis).

But I'm not going to do that now.  Instead, I'd like to mention the people left out, because Pennsylvania chose not to expand its Medicaid program in 2014. Thanks to the Kaiser Family Foundation, we have national and state-specific estimates of people who fall into this coverage gap in 25 states not expanding Medicaid this year.  KFF estimates that 4.8 million people nationally—nonelderly, poor, and uninsured—will be left out of the ACA health reforms.  Six per cent of them live in Pennsylvania.

Across the state, 281,000 adults fall into this coverage gap. Of those, 180,000 are white; 62,000 are black, and 29,000 are Hispanic.  The vast majority (81%) are adults without dependent children; 42% are women.  And fully 60% are in a family with at least one worker.  They are ineligible for subsidies on the individual market (because they are below poverty level) and will most likely remain uninsured because they have no affordable coverage options.

The story of Gov. Corbett's proposed plan is still unfolding.  To implement the plan, Pennsylvania needs a federal waiver of multiple Medicaid requirements. By rule, the waiver application must undergo a one month public comment period in Pennsylvania (six hearings are scheduled across the state), then another one-month federal comment period after it is submitted. If all goes according to plan, Gov. Corbett proposes a January 2015 start date.  But to 281,000 people in Pennsylvania, that's a long wait.

Editor's Note: Cross-posted on the Voices@LDI blog of the Leonard Davis Institute of the University of Pennsylvania.