ObamaCare Medicaid Expansion is one of the biggest milestones in health care reform. ObamaCare’s Medicaid expansion expands Medicaid to our nations poorest in order cover nearly half of uninsured Americans. The law previously required states to cover their poorest or lose federal funding to Medicaid (federal funding covers 90-100% of state costs) until the Supreme Court ruling on ObamaCare.
State’s can now opt-out of Medicaid Expansion leaving millions of poor working families without coverage. Medicaid Expansion would cover about half of the uninsured in America if all states opt-in.
But, alas…Pennsylvania, under the “leadership” of governor Corbett has chosen to opt out.
Instead, he has decided to follow the lead of several other “Red’ state governors, and attempt to create a different approach to insuring those most in need of health insurance.
His “plan” is called Healthy PA.
According to the Executive summary of the alternative to Medicaid Expansion that was submitted to the Secretary Kathleen Sebelius Governor Corbett’s plans states,
“Healthy Pennsylvania is Governor Tom Corbett’s plan to ensure that Pennsylvanians have increased access to quality, affordable health care. Governor Corbett’s Healthy Pennsylvania plan focuses on three key priorities: improving access, ensuring quality, and providing affordability. It touches all areas of health care to encourage better care coordination for patients, providers, and insurers. It is built upon common sense reforms that provide coverage options to our most vulnerable citizens in a flexible and sustainable way that protects taxpayers. The Medicaid reforms and the Private Coverage Option encompassed in the Healthy Pennsylvania plan will:
1. Increase health care access for more than 500,000 Pennsylvanians.
2. Promote healthy behaviors, improve health outcomes and increase personal responsibility.
3. Provide benefits that match health care needs.
4. Implement a strategy for sustainability by reforming the current Medicaid program to align it with private health care coverage.”
It’s not as though the concept of Medicaid is unproven. Medicaid was designed to provide health coverage for low-income children and families who lack access to private health insurance because of their limited finances, health status, and/or severe physical, mental health, intellectual, or developmental disabilities. Medicaid also assists low-income elderly and disabled Medicare beneficiaries with their Medicare premiums and cost-sharing and covers important benefits that Medicare does not cover, especially long-term care. Medicaid, the nation’s main public health insurance program for low-income people, now covers over 65 million Americans – more than 1 in every 5 – at least some time during the year.
One in six Pennsylvanians receives Medicaid. By 2020, as the state’s population rapidly ages, that number could be one in four. So even if Medicaid doesn’t touch your life, or the life of someone you love, projections are that it very well could in the coming years. The program’s beneficiaries include many of the most disadvantaged individuals and families in the U.S. in terms of poverty, poor health, and disability. Since its’ inception 45 years ago, The Institute of Medicine has reported that, “It is also associated with having a regular source of care and with greater and more appropriate use of health services. These factors, in turn, improve the likelihood of disease screening and early detection, the management of chronic illness, and effective treatment of acute conditions such as traumatic brain injury and heart attacks. The ultimate result is improved health outcomes.”
The ObamaCare Medicaid reforms that come with ObamaCare’s Medicaid Expansion include raising the amount doctors get paid to the same level of Medicare (73%) and increasing payments to Medicaid programs that offer preventive services for free or at little cost. New free preventive services include tests for high blood pressure, diabetes, and high cholesterol; many cancer screenings, including colonoscopies and mammograms; counseling to help people lose weight, quit smoking or reduce alcohol use; routine vaccinations; flu and pneumonia shots; and other services.
New York, Arizona and Maine expanded Medicaid between 2000 and 2005. A Harvard study reports, “rates of uninsured residents dropped, access to care improved, and more people reported being in very good or excellent health”. The coverage was estimated to save a total of 2,840 lives a year for the states.
Healthy PA could take as long as a year to a year and a half for the federal government to tell us what it will accept or not. Healthy PA will delay access to covered lives, and is an unproven model that could put the providers and health systems we all depend on, regardless of the type of insurance you have, at risk for bad debt and other financial liabilities associated with cuts to federal funding programs.
This is a shaky proposition at best. The first program of its kind in Arkansas is already in danger of ending after just 6 weeks.
Although it is presented as Pennsylvania’s Medicaid Expansion proposal, it would also cut benefits for the more-than-1,000,000 current Medicaid recipients in Pennsylvania. In addition to cuts in benefits, the plan proposes new cost-sharing (fees for participants) and a job search or employment requirement. That’s right…a co-pay for Medicaid!
Imagine, if Pennsylvania’s application were approved, it would mark the first time any state has ever tied a work-search requirement to its Medicaid program.
Even the Governor admits, “Pennsylvania is (already) home to a robust, world-class health care delivery.”
Pennsylvania currently has a successful model of Medicaid Managed Care that has been working well, and continuously receives national acclaim. All we really need is for Pennsylvania to be allowed to continue to provide quality health care under Medicaid Expansion.
To put it plainly…Gov. Corbett’s proposed plan creates barriers for people to get the coverage they need, most notably requirements for work searches, premium costs, new screening instruments and retroactivity. For example, if a family misses three consecutive insurance premium payments, they lose their health coverage and will also be forced to wait three months to reapply for the health insurance program, thereby created a new pool of the uninsured.
What can you do now?
The federal government is allowing a 30-day public comment period for the Governor’s plan as they consider whether to approve it or not.
The comment period is due to close on March 28th 2014 4:00 pm. There is not a lot of time to make your voices heard.
If You Don’t Want Your State To Reject Medicaid Expansion For Your State’s Poorest, Call your state legislatures and tell them to keep Pennsylvania’s current Medical Assistance program. Written comments can also be submitted to The Department of Public Welfare via e-mail at RA-PWHealthyPA1115@pa.gov, or sent by regular mail to the following address:
Department of Public Welfare
Attention: Healthy Pennsylvania Waiver
P.O. Box 2675
Harrisburg, PA 17105-2675, or go online at: https://public.medicaid.gov/connect.ti/public.comments/view?objectid=1852995
Please, Please, Please get involved before it’s too late…
