Medicaid

Flickr user Alex Proimos

The Wolf administration has announced its timeline for the transition to a traditional Medicaid expansion.

Beginning in April, the Pennsylvania Department of Human Services will transfer individuals enrolled in the General Assistance and Select Plan programs from the private coverage option (PCO) to the new Adult benefit package, dubbed HealthChoices.

Governor Wolf Begins Dismantling Corbett’s Healthy PA Program

Feb 10, 2015
Governor Tom Wolf / Flickr

When Tom Wolf was campaigning for Governor, he said he would do away with then-Governor Tom Corbett's Healthy PA plan, and replace it with a full Medicaid expansion supported by the Affordable Care Act.

This week Gov. Wolf officially announced plans to transition from Healthy PA to the Medicaid expansion. We'll talk about the implications of this change with Antoinette Kraus, Director of PA Health Access Network.

Kraus says that her organization is relieved to see that Healthy PA will be phased out and the Medicaid expansion will be implemented. The PA Health Access Network has worked to enroll hundreds of Pennsylvanians in Healthy PA, but she says that the program has been complicated and bureaucratic, with substantial limits on accessing care and benefits.

AP Photo/Matt Rourke, File

Gov. Tom Wolf's administration on Monday announced it is simplifying the benefits packages for adult Medicaid recipients.

Wolf's administration released letter to the federal government saying it is withdrawing a request from former Gov. Tom Corbett for approval of a low-risk benefits package for healthier adults.

The federally-approved waiver for Medicaid expansion in Pennsylvania is set to begin covering hundreds of thousands of newly eligible Pennsylvanians in January. Depending on who’s governor-elect at that point, there may be some changes.

Democratic nominee Tom Wolf has said he would implement a full Medicaid expansion if elected governor in November.

90.5 WESA is exploring several of the key issues being debated as part of the 2014 Pennsylvania gubernatorial campaign.

Medicaid Expansion

Gov. Tom Corbett’s Healthy Pennsylvania substitute for the federal Medicaid expansion was officially accepted by the Department of Health and Human Services on August 28. The plan would use federal subsidies to offer private insurance plans to more than 600,000 low-income residents who qualify.

Policy analysts are staying tuned for additional changes to Medicaid benefits for current enrollees in Pennsylvania.

Federal officials set aside Gov. Tom Corbett’s proposal to curb Medicaid benefits when they considered his overall plan to expand health care coverage for the working poor by using private insurance plans. But the changes still under negotiation could limit things like wheelchairs, homecare visits and physical therapy for Medicaid enrollees.

Healthcare advocates, along with State Rep. Dan Frankel (D-Allegheny), unveiled an online ticker today, which tracks the amount of money they claim Pennsylvania is losing by rejecting Medicaid expansion.

As of today, the state has missed out on more than $640 million since the start of 2014, according to the ticker.

“It’s hard to turn your back against this when it addresses so many important issues facing the state at this time,” Frankel said.

About 40 members of the public spoke out at the seventh and final hearing on the Corbett's administration's Medicaid overhaul plan Thursday in Harrisburg.
     
State Rep. Gene DiGirolamo was among them.
     
The Bucks County Republican said the state should accept federal Medicaid expansion dollars now while it continues to negotiate an alternative plan with the federal government.
    
But Department of Public Welfare Secretary Bev Mackereth suggested it's not a financially viable option without the reforms they're proposing.
     

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The Corbett Administration is making details of its alternative proposal to the Affordable Care Act's Medicaid expansion available to the public.

The Governor recently held a presser on his health care plan days after releasing it online. The plan, which would allow hundreds of thousands of people to enroll in private health insurance plans subsidized with federal funds, is one step closer to receiving federal review.

90.5 WESA's Capitol Bureau Chief Mary Wilson reports on the plan from Harrisburg and says the proposal is similar to those of other states, but includes a few elements unique to the Commonwealth’s needs.

The U.S. Department of Health and Human Services said Wednesday that people will have more options in the health insurance marketplace and premiums will not be as high as originally thought. 

Premiums nationwide will be about 16 percent lower than originally expected.

“In the past, consumers were too often denied or priced-out of quality health insurance options, but thanks to the Affordable Care Act, consumers will be able to choose from a number of new coverage options at a price that is affordable,” Secretary Kathleen Sebelius said in a statement. 

The Corbett administration insists it doesn’t need legislative approval to go forward with its overhaul plan for Medicaid, despite some cries to the contrary.

The governor has linked his acceptance of federal funding for private health coverage for low-income residents to a separate plan to change Medicaid benefits and add a work-search requirement.

Todd Shamash, a deputy chief of staff in the governor’s office, says Corbett doesn’t need legislative say-so to go forward, as long as federal officials approve.

Part of the Gov. Tom Corbett's Medicaid plan includes health care policy changes that remain in the hands of the state Legislature, including one bill supporters say would reduce prescription drug abuse.

The governor called on state lawmakers to expand the state's medication tracking database. The current system monitors only certain drugs, and law enforcement alone has access to the information.

A bill before the state House would expand the database to track all controlled substances. It would also let doctors and pharmacists check the database.

90.5 WESA

Governor Tom Corbett’s medicaid expansion plan sounds like “a step in the right direction” according to Erin Ninehouser, the Education and Outreach Director for Pennsylvania Health Access Network, but she does have some reservations.

Republican Gov. Tom Corbett’s plan to reform Medicaid and extend federally subsidized private health coverage to half a million more Pennsylvanians is riling up the staunch conservatives within his party.
    
GOP state Representative Daryl Metcalfe of Butler County says he’s calling the proposal an expansion, even if the governor isn’t using the same language.

Mary Wilson / 90.5 WESA

Gov. Tom Corbett is proposing a way for about half a million low-income Pennsylvanians to get access to health insurance, but only if the federal government signs off on reforms to the state's traditional Medicaid program.

The proposal includes replacing Medicaid co-pays with monthly premiums that will range from zero to $25 a month per person based on a recipient's income. The governor also wants to require working-age Medicaid recipients, with some undefined exceptions, to show they're looking for work or getting job training.

Thirteen of the Pittsburgh region’s nursing homes are taking part in a federal Centers for Medicare and Medicaid Services (CMS) initiative to reduce the number of nursing home residents who are re-admitted to the hospital within 30 days.

Four of those 13  are the Kane Regional Centers in McKeesport, Glen Hazel, Ross and Scott Township.  Those centers are receiving an in-house nurse practitioner and employee training designed to help pick out situations that need medical intervention.

Doctors, hospitals and patients are now more connected than ever as the majority of health care providers in the United States are making the switch to electronic health records.

The U.S. Department of Health and Human Services announced recently that it already exceeded its goal for 50 percent of doctor’s offices and 80 percent of eligible hospitals to use EHRs by the end of 2013.

According to a 2012 Centers for Disease Control and Prevention survey, 17 percent of physicians and 9 percent of hospitals were using EHRs in 2008.