DHS Secretary Says No to Medicaid Work Requirements

Pennsylvania will not seek federal permission to create a Medicaid work requirement, Department of Human Services Secretary Teresa Miller told a joint hearing of the State Senate Republican Policy Committee and Health and Human Services Committee this week.

Miller conveyed what a news release described as

…the Wolf Administration’s firm opposition to work requirements for Medicaid recipients and the administration’s work to expand access to education and training programs and services to support employment for people served by DHS’ programs.

In her testimony, Miller explained that

Our goal is always to set policy and implement programs that empower Pennsylvanians to live fulfilling lives, support themselves and their families, contribute to our local economies, and build stronger communities.  This is not about opposition to work. We want all people to achieve a better quality of life and not be caught in an intergenerational cycle of poverty. The Wolf Administration is not simply opposed to a work requirement; we are committed to increasing opportunities for meaningful work and providing the whole-person supports we contend are needed.

A Medicaid work requirement could affect the Medicaid eligibility of patients served by Pennsylvania’s safety-net hospitals.

Learn more about Secretary Miller’s testimony in this Department of Human Services news release.

Filed under: Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals

Change Coming to PA’s Medicaid Transportation Program

Pennsylvania’s Medicaid transportation program will soon be undergoing major change.

By law, states must provide free non-emergency medical transportation for their Medicaid recipients.  The Pennsylvania Medical Assistance Transportation Program has fulfilled that mandate for the past 35 years, with county governments shouldering primary responsibility for providing or arranging for the transportation for their Medicaid-covered residents.

Under a plan adopted by the Pennsylvania Department of Human Services, which administers the state’s Medicaid program, that would change, with the state currently reviewing proposals from private vendors that would serve as brokers and assume this responsibility for large sections of the state:  the eastern, central, and western parts of Pennsylvania.

Changing the program in this manner would enable Pennsylvania to change the classification of medical transportation from an administrative cost to a service cost, which would drawn down more federal Medicaid matching funds and save the state about $10 million a year.

Learn more about what the state is doing, why it is doing it, and why some people believe the new approach may be more expensive and less effective in the Philadelphia Inquirer article “As changes come to Pa. Medicaid transportation program, counties fear bumps in road.”


Filed under: Pennsylvania Medicaid policy, Pennsylvania Medical Assistance

Opioid Prescriptions Down in PA

Pennsylvania doctors are writing fewer prescriptions for opioids, according to a new analysis by the American Medical Association.

According to the AMA, prescriptions for opioids declined 40 percent in the state between 2013 and 2018 – one of the largest declines in the country.

In a news release, the Pennsylvania Medical Society attributed the decline in part to physician education and in part to the state’s prescription drug monitoring programs.

Learn more from the Central Pennsylvania Business Journal article “Pa. physicians writing fewer opioid prescriptions” and from a news release from the Pennsylvania Medical Society.

Filed under: Uncategorized

PA May Take Over Insurance Exchange

Pennsylvania may soon assume responsibility for providing a health insurance exchange for its residents.

When the Affordable Care Act was adopted in 2010, states were given the option of establishing their own marketplaces for health insurance offered under the reform law or having their citizens use a federal exchange established for the same purpose.  Pennsylvania chose to have its residents use the federal exchange, but now, a law changing that is making its way through the state legislature.

Harrisburg, PA capital buildingHouse Bill 3, with more than 80 sponsors from both parties, would direct the state to establish its own health insurance exchange and establish a Pennsylvania Health Insurance Exchange Fund to pay for it.

After years of ceding this responsibility to the federal government, some state lawmakers now believe the state can run its own exchange more efficiently and save money by operating the exchange for less than it currently pays the federal government for use of the federal exchange.  The bill’s sponsors also believe that taking over the exchange will enable the state to seek a federal reinsurance waiver that should reduce health insurance premiums five to ten percent in Pennsylvania.

House Bill 3 will be considered by the House Insurance Committee.

Learn more about what members of the House seek in the WITF radio article “Plan for Pennsylvania to take over health insurance marketplace gaining ground”; read a co-sponsor memo to state House members asking them to co-sponsor the bill; and read House Bill 3 itself.


Filed under: Affordable Care Act

Legislature to Examine Mental Health Provider Shortage

Pennsylvania’s apparent shortage of mental health providers will be the subject of study by the Pennsylvania Joint State Government Commission, a bipartisan arm of the state’s General Assembly.

The resolution to conduct the study was approved unanimously by the state House, and according to a news release from state representative Jeanne McNeill, who sponsored the resolution,

The study will work to identify factors behind the state shortages, make projections on the number of mental health care providers in Pennsylvania in the future, make recommendations on how to solve the disparity in the number of mental health care providers in rural counties compared to urban and suburban counties and any other solutions needed to stop and reverse the mental health care provider shortage.

Learn more about the mental health provider shortage and the legislature’s search for solutions to that problem in the Central Penn Business Journal article “Panel to study mental health care shortage in PA” and from Representative O’Neill’s news release.

Filed under: Uncategorized

Administration Ramps Up Scrutiny of Immigrants’ Use of Public Benefits

Immigrants’ sponsors could be more likely to be held financially responsible for the cost of public benefits those immigrants receive under a new memorandum issued by the White House.

The requirement itself is not new; the purpose of the memorandum is to encourage federal agencies to enforce existing laws that state that, according to the memorandum,

…when an alien applies for certain means-tested public benefits, the financial resources of the alien’s sponsor must be counted as part of the alien’s financial resources in determining both eligibility for the benefits and the amount of benefits that may be awarded.  Financial sponsors who pledge to financially support the sponsored alien in the event the alien applies for or receives public benefits will be expected to fulfill their commitment under law.

Among the means-tested public benefits programs at which this new directive is aimed are Medicaid, the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps), and Temporary Assistance for Needy Families (TANF).

While the law already requires agencies to enforce immigrants sponsors’ legal financial responsibilities, the White House memorandum notes that it is not being enforced and directs the federal agencies involved to review and update their enforcement procedures.

Enforcement of this directive could result in fewer people applying for and being found eligible to receive Medicaid. If this occurs, it could be especially harmful to Pennsylvania safety-net hospitals that serve large immigrant communities, potentially leaving them unpaid for care they provide to such patients.

Learn more from the administration’s “Memorandum on Enforcing the Legal Responsibilities of Sponsors of Aliens.”

Filed under: Federal Medicaid issues, Pennsylvania safety-net hospitals

Medicaid Expansion Helps Pregnant Women and Their Babies

An intuitive assumption now has evidence to support it:  Medicaid expansion has improved the health of pregnant women and their babies.

According to a new study from the Georgetown University Health Policy Institute’s Center for Children and Families,

…states that expand Medicaid improve the health of women of childbearing age:  increasing access to preventive care, reducing adverse health outcomes before, during and after pregnancies, and reducing maternal mortality rates.

Better health for women of childbearing age also means better health for their infants.  States that have expanded Medicaid under the Affordable Care Act saw a 50 percent greater reduction in infant mortality than non-expansion states.

The report notes that the number of uninsured women of childbearing age in Pennsylvania fell 49 percent during the three years after Pennsylvania expanded its Medicaid program.  Significant numbers of these newly insured women are served by Pennsylvania safety-net hospitals.

Learn more, including specific health benefits enjoyed by pregnant women and their babies, in the Georgetown study “Medicaid Expansion Fills Gaps in Maternal Health Coverage Leading to Healthier Mothers and Babies.”


Filed under: Affordable Care Act, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals

Medicaid DSH Delay Wins Bipartisan Support

More than 300 members of the U.S. House have joined a letter to House leadership urging a delay in Affordable Care Act-mandated cuts in Medicaid disproportionate share payments (Medicaid DSH).

The bipartisan letter notes that hospitals that receive Medicaid DSH funds cannot absorb the loss of revenue such a cut would bring.  That cut, scheduled to begin in FY 2020, would amount to a $4 billion reduction in nation-wide Medicaid DSH spending in FY 2020 and an $8 billion reduction in each of FY 2021, FY 2022, FY 2023, FY 2024, and FY 2025.

Safety-Net Association of Pennsylvania logoSNAP was actively involved in urging Pennsylvania House members to join the letter.  If implemented, the Medicaid DSH cuts would be especially harmful to SNAP members and all Pennsylvania safety-net hospitals – and to the low-income residents of the communities they serve.

See the bipartisan letter seeking a delay of Medicaid DSH cuts here.


Filed under: Affordable Care Act, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments

PHC4 Reports on PA Hospital Financial Performance

Pennsylvania hospitals’ financial performance in 2018 was mixed, according to a new analysis by the Pennsylvania Health Care Cost Containment Council.

According to PHC4,

  • uncompensated care declined two percent
  • total margins fell 0.05 percentage points
  • operating margins declined 0.39 percentage points
  • net patient revenue rose 3.9 percent
  • discharges fell 1.2 percent
  • inpatient days fell 0.3 percent

Learn more about the 2018 financial performance of acute-care hospitals in Pennsylvania, including data for every such hospital in the state and measures such as payer mix, in the PHC4 report Financial Analysis 2018:  General Acute Care Hospitals

Filed under: Uncategorized

SNAP Joins Letter Urging Preservation of Tobacco Funding

The Safety-Net Association of Pennsylvania has joined 10 other organizations in urging Pennsylvania’s General Assembly to use 100 percent of Tobacco Settlement Fund monies for health-related services and programs in the coming fiscal year.

Safety-Net Association of Pennsylvania logoFor FY 2018-2019, Pennsylvania borrowed against future proceeds from the Tobacco Settlement Fund to help balance the state budget.  Debt service payments will soon be due and the Wolf administration has proposed paying that debt service with proceeds from the state’s sales and use taxes.  In a letter to state legislators, SNAP and the others endorse this aspect of the administration’s proposed budget FY 2019-2020 budget.

Tobacco fund proceeds are vital to Pennsylvania’s safety-net hospitals, helping to compensate them for some of the care they provide to uninsured and underinsured residents of the communities they serve.  Funds used in this manner, moreover, are matched by the federal government, doubling their impact on communities in need.

See the letter here.


Filed under: Medicaid supplemental payments, Pennsylvania proposed FY 2020 budget, Pennsylvania safety-net hospitals

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2012 Safety-Net Association of Pennsylvania