A look at Pennsylvania’s new Medicaid option, one week in

Newsworks

January 8, 2015

By Elana Gordon,

State officials estimate that as of January 1, 2015 about 600,000 Pennsylvanians became eligible for Medicaid through its newly expanded Healthy Pennsylvania option.

Enrollment began last month, and as of Monday, a spokesperson reported the state had received at least 114,000 household applications (it’s unclear how many came from people who were previously uninsured).

[…]

Starting last January, states began tapping into federal funding to expand the number of people eligible for medicaid by broadening the income guidelines to just above the poverty line.

It means able-bodied, childless adults earning up to about $16,000 a year are eligible, as are more families. A family of four with an annual income of up to about $30,000, for example, now qualifies for Medicaid.

“Pennsylvania was really the last state in its region to move ahead to expanding coverage to those in the coverage gap,” said Joan Alker, a Medicaid expert and director of Georgetown University’s Center for Children and Families.

Alker is referring to neighboring Delaware, Ohio, Maryland and New Jersey that have already expanded Medicaid in some form.

“There’s a lot of complicated nuances to the governor’s plan,” said Alker, pointing to consumer protection mechanisms that will now involve the state’s department of insurance.

[…]

Alker says this is actually not much different from how Medicaid in Pennsylvania already operates.

“Medicaid already uses [those] private insurers to deliver services through managed care,” she said. “So potentially what would have been different really is coming next year in 2016.”

[…]

Regardless, Alker says Corbett’s original proposal – with its focus on job training, charging premiums, and trying to establish healthy behavior requirements – is sure to influence other states who may be considering an alternative proposal in the coming year.

In fact, she expects any state moving forward with an expansion will attempt the waiver approach.

“Those are themes I expect we’ll see continue to be discussed,” said Alker. “And certainly the governor participated and contributed to those ongoing discussions that we’re seeing around the country in those emerging areas.”

 

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