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Pa. governor posts draft of application for Medicaid exchange waiver

Modern Healthcare 

December 06, 2013

By Virgil Dickson,

Pennsylvania Republican Gov. Tom Corbett posted a draft copy of an application for a Medicaid waiver that would allow the state to collect federal Medicaid funds to help low-income residents buy coverage in the health insurance exchange established under the Patient Protection and Affordable Care Act.

The 100-page draft waiver is consistent with a “concept” paper Corbett released earlier this fall. In addition to following Arkansas’ lead in steering Medicaid beneficiaries into private insurance plans, it calls for those who make more than 50% of the federal poverty level to pay monthly premiums, and it would require working-age recipients to prove they’re employed or actively looking for work.The plan would extend coverage as many as 500,000 of the state’s poorest residents beginning Jan. 1, 2015.

Joan Alker, executive director of the Georgetown Center for Children and Families, said Pennsylvania’s waiver “is personally irresponsible and can’t get approved, and it’s bad policy.” She took particular issue with the work requirement, calling it “counterproductive, because if you want people to work they need to be healthy.”

Deborah Bachrach, a partner in the law firm of Manatt, Phelps & Phillips who advised Arkansas on its successful waiver application, said it may take the CMS a long time to decide whether the benefits of expanding eligibility are undermined by the other elements of the plan.

Before the waiver is submitted to the CMS, there will be a statewide public comment period for 30 days, which includes six public hearings across the state.