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Advocates View Medicaid Expansion Alternative With Guarded Optimism

A day after it was announced that Gov. Tom Corbett’s alternative to Medicaid expansion, Healthy PA was approved by the federal government, health care advocates in Pennsylvania lauded the move as good overall but voiced concerns over high premiums and the logistics of establishing an entirely new system.

“We don’t believe that this is the best way to cover 600,000 Pennsylvanians,” said Kristen Dama, staff attorney at Philadelphia-based Community Legal Services.

The final proposal is different from the original plan submitted by Pennsylvania’s Department of Public Welfare, with some elements the advocates call “harmful” removed.

The plan will use federal monies to subsidize private-insurance plans for low-income Pennsylvanians. The Corbett administration expects that more than 600,000 people, many of whom were previously uninsured, will be eligible.

With this comes changes to the state’s existing Medicaid program, such as the requirement to pay premiums for people at 100 percent of the federal poverty level. That’s a person making $12,000 a year or a family of four living on $24,000. Anyone who doesn’t make those premiums for three consecutive months could be un-enrolled.

Dama recalled other problems the state’s Medicaid program has had in recent years and voiced concerns as to how people will be able to move between the systems as their financial situations change.

“In just a few months, we’re going to build this entirely distinct system, and there’s real worries about how the two systems are going to talk to each other — the existing Medicaid system and the new Medicaid system,” she said.

About 55,000 who are now in the Medicaid program will be ineligible next year and will have to switch to private plans.

Enrollment will start in December. Participation will begin in January.