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Archive for September 2013

The Underlying Rationale For “Healthy Pennsylvania”

Reducing costs. Sustainability. Simplification. These are among the reasons that members of the Corbett administration offer for why the Medicaid expansion components of the governor’s Healthy Pennsylvania proposal are structured as they are. The online publication PA Independent talked to a number of administration officials about why they have chosen the proposed path to health care reform in the state.  Read what they had to say in the article “PA looks to reform Medicaid, stave off cost increases” here, on the PA Independent web site.

Posted in Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy

CMS Proposes Basic Health Program

The Centers for Medicare & Medicaid Services (CMS) has unveiled a proposal to establish what it is calling a “Basic Health Program” that gives states “the option to establish a health benefits coverage program for low-income individuals who would otherwise be eligible to purchase coverage through the Health Insurance Marketplace.” The program, established in the Affordable Care Act, is designed for people who do not qualify for Medicaid or CHIP and whose incomes are between 133 percent and 200 percent of the federal poverty level.  Legal residents who are non-citizens whose incomes are below 133 percent of the federal poverty level also qualify.  The federal government is picking up 95 percent of the cost of this program. A new proposed … Read More

Posted in Affordable Care Act

First Peek at PA’s Health Insurance Exchange

A new report from the U.S. Department of Health and Human Services offers a first look at the health insurance choices to be available to residents of 36 states, including Pennsylvania. According to the report, premiums before subsidies – not yet released publicly – will average about 16 percent lower than Congressional Budget Office projections. Across the state, Pennsylvanians will average a choice of 56 insurance plans.  The selection varies by region, with 42 choices for residents of the Philadelphia area and 36 for those who reside in Pittsburgh. The health insurance exchanges are one of the main features of the Affordable Care Act. Rate information for the individual plans will be released next Tuesday, but monthly premiums for Pennsylvanians … Read More

Posted in Affordable Care Act

ACA Insurance Subsidies for 900,000 Pennsylvanians?

As many as 900,000 Pennsylvanians could be eligible on October 1 for the insurance premium subsidies that are a major part of the Affordable Care Act, according to the advocacy group Families USA. Learn more about the subsidies, who qualifies for them, and how they work in this WHYY Newsworks article.

Posted in Affordable Care Act

CMS Finalizes Medicaid DSH Cuts

The Centers for Medicare & Medicaid Services (CMS) has issued a final Medicaid disproportionate share (Medicaid DSH) regulation that cuts federal spending on Medicaid DSH $500 million in FY 2014 and $600 million in FY 2015. The Medicaid DSH cuts were mandated by the Affordable Care Act in anticipation of every state expanding its Medicaid program.  The reform law’s Medicaid expansion mandate was later made optional by a Supreme Court ruling. Medicaid DSH cuts will hurt all Pennsylvania safety-net hospitals, and the Safety-Net Association of Pennsylvania (SNAP) has conveyed its opposition to the cuts to CMS and also has asked members of Pennsylvania’s congressional delegation to support current legislation to delay the implementation of both Medicaid DSH and Medicare DSH … Read More

Posted in Affordable Care Act, Pennsylvania Medicaid policy

Medicaid Patients Get Comparable Face Time With Primary Care Docs

Primary care physicians do not spend less time with their Medicaid patients, a new study has concluded. While Medicaid patients may face greater challenges finding primary care physicians who will serve them, once they find one, those doctors will spend no less time with them than they do with their commercially insured patients.  Medicaid patients also receive more diagnostic and treatment services than their commercial counterparts as well as no less attention to preventive care. Learn more about the findings of George Washington University researchers in the article “No Evidence That Primary Care Physicians Offer Less Care to Medicaid, Community Health Center, or Uninsured Patients” here, on the web site of the journal Health Affairs.

Posted in Uncategorized

More Than Better Pay Needed to Lure Docs to Medicaid

Primary care physicians want more than better reimbursement as an inducement to serve more Medicaid patients. They also want simpler administrative procedures, faster payment, and lower costs associated with treating those patients. These findings come from a survey of primary care physicians in Washington state. Recruiting more primary care physicians to serve Medicaid patients is more important than ever because many states will be taking advantage of Affordable Care Act incentives to expand eligibility for their Medicaid programs. The survey results and more can be found in the article “Physicians May Need More Than Higher Reimbursements to Expand Medicaid Participation:  Findings From Washington State,” which was published in the September 2013 edition of the journal Health Affairs.  Find that article … Read More

Posted in Affordable Care Act, Pennsylvania Medicaid policy

Corbett Presents Health Care, Medicaid Proposal

Pennsylvania Governor Tom Corbett has unveiled a new “Healthy PA” proposal that includes the means through which the state would extend Medicaid coverage to approximately 520,000 additional people. The new Medicaid recipients, instead of enrolling in the state’s traditional Medicaid program, would purchase their health insurance through the state’s health insurance exchange, a creation of the Affordable Care Act. Funding for the new recipients would come almost entirely from the federal government, also through the Affordable Care Act. Pennsylvania has long been one of the states that has resisted expanding its Medicaid population – a decision made optional by the Supreme Court after a challenge to the 2010 reform law’s constitutionality. Read a summary of the Healthy PA plan, and … Read More

Posted in Affordable Care Act, Pennsylvania Medicaid policy

Reform Will Give Medicaid Population a New Look

Once the Affordable Care Act’s Medicaid expansion is implemented, the Medicaid population as a whole will be younger, whiter, healthier, and more male but also more likely to smoke and drink to excess than it is today. That is the conclusion reached by in a new report published in the Annals of Family Medicine. This means that spending per recipient may not be as great for new Medicaid recipients as it is for current beneficiaries and that a different patient population may need different approaches to addressing different health challenges. Learn more about the study and its implications in the article “Potential Adult Medicaid Beneficiaries Under the Patient Protection and Affordable Care Act Compared With Current Adult Medicaid Beneficiaries, which … Read More

Posted in Affordable Care Act, Health care reform

Legislature to Participate in PA Medicaid Expansion Talks

The Corbett administration plans to spend the coming weeks bringing the state legislature into it Medicaid expansion deliberations. While the administration reportedly has been working to develop a Medicaid expansion program that meets its own requirements for financial responsibility and will pass federal muster, it has been doing so largely without consulting with the state legislature, which has been in recess since early July.  While legislative approval is not needed for most aspects of Medicaid expansion, Department of Public Welfare Secretary Bev Mackereth told the Pittsburgh Post-Gazette that the administration will begin consulting with the legislature. Medicaid expansion, originally mandated by the Affordable Care Act, was made optional for states by a Supreme Court decisions.  Only about half of the … Read More

Posted in Affordable Care Act, Health care reform, Pennsylvania Medicaid policy
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