The Morning Call
January 22, 2014
By Steve Esack and Tim Darragh,
Corbett, an opponent of the nation’s health care law, wants families to have the choice to choose CHIP.
The agreement mandates Corbett move income-eligible families into Medicaid by 2015. As part of the deal, the state also agreed to offer affected families the choice of moving into Medicaid before 2015.
“This is a win-win for everybody involved, most particularly the current CHIP families,” state Insurance Commissioner Michael Consedine said in an interview.
Senate Democrats had a different reaction.
The agreement is a win because income-eligible families finally can move into Medicaid to receive better insurance coverage, particularly if their children need mental and behavioral-health services, said Ben Waxman, spokesman for Sen. Vince Hughes, minority chairman of the Senate Appropriations Committee.
“They are moving into a better insurance and that’s something … we obviously support,” Waxman said.
Joan Alker, executive director of the Center for Children and Families at the Georgetown Health Policy Institute, said it was a split decision. Corbett got permission to delay the transfer of children from one program to the other. “He didn’t get permission, however, to leave kids there for the foreseeable future,” she said, referring to CHIP.
While Medicaid may offer more services, more doctors accept CHIP, potentially leaving some families scouring for doctors in some parts of the state.
Despite doctors’ preference for CHIP, far more children are covered under Medicaid than CHIP.
As of October, nearly 1.1 million Pennsylvania children were enrolled in Medicaid and 188,098 children in CHIP, according to the state Department of Welfare.
The Affordable Care Act, commonly referred to as Obamacare, required states to move children whose parents earn between 100 percent and 133 percent of poverty level into Medicaid as of Jan. 1, 2014. That poverty threshold equals $19,530 to $25,975 for a three-member household, the U.S. average.
Corbett had fought that mandate since Obamacare went into effect as he has other aspects of the law, including suing to overturn the law while he was attorney general. No other governor had objected to making the CHIP-to-Medicaid switch, although some governors had requested, and received, permission to gradually move children into Medicaid instead of doing it en mass when they could not meet the deadline.
Corbett’s administration never started the transition in the three years the law has been in effect. Instead it sought special status, arguing Pennsylvania should be able to keep its CHIP program because it was the first state to implement one.
Since 1992, CHIP has provided government subsidies so income-eligible families can buy private insurance for children. Its success prompted Congress to pass a national CHIP law in 1997, allowing the state to receive federal payments to help operate it.
After months of negotiations, Corbett announced on Dec. 12 that the federal government had agreed to his requests to not move children into Medicaid on the first of the new year. Corbett sought to make that deal everlasting; the federal government said no.
The decision followed a decades-old federal regulation precluding states from letting income-eligible families pick between CHIP or Medicaid.
Without Corbett fighting for family’s rights, Consedine said, parents would not have had the choice of keeping CHIP this year. The extension, he said, gives families more time to decide which insurance program is best for them.
“It gives them the ability to make an informed choice for what works best for their kids,” Consedine said. “The governor believes parents, not the federal government, should be making that decision.”
The state will begin issuing letters next week to affected families.
