Archive for Healthy PA
150,000 Pennsylvanians have enrolled in Medicaid since the Wolf administration officially launched its HealthChoices expansion on April 27. Added to the 289,000 who enrolled during the Corbett administration’s Healthy Pennsylvania program, that means about 439,000 Pennsylvanians have obtained Medicaid coverage since the state expanded its Medicaid program as authorized by the 2010 federal health care reform law. To learn more about the latest Medicaid enrollments, their financial impact on the state, and how the HealthChoices expansion works, see this Wolf administration news release.
While most states that have taken advantage of the Affordable Care Act’s Medicaid expansion have simply expanded their existing Medicaid programs to incorporate the newly eligible, six states have taken a different path, pursuing what are known as section 1115 waivers – waivers of formal Medicaid requirements – to expand their Medicaid programs in different ways. Typically, those different ways involve coverage modeled on private sector insurance practices, including requiring the newly eligible to choose from among approved managed care plans on the private market; the elimination of some traditional Medicaid benefits; the imposition of work requirements and higher premiums; and more. In the new report Medicaid Expansion, The Private Option and Personal Responsibility Requirements: The Use of Section 1115 … Read More
Last weekend Pennsylvania’s Department of Human Services (DHS) formally moved more than 121,000 people from the Corbett administration’s Healthy Pennsylvania Medicaid expansion program to the Wolf administration’s expansion of the state’s long-time HealthChoices Medicaid managed care program. Those who were shifted had enrolled in Healthy Pennsylvania private coverage option (PCO) plans before the end of calendar year 2014. In the next few days they will receive written notification of the shift. All will receive the same Medicaid benefits: a basic adult benefit package. Individuals will no longer be able to enroll in PCO plans, and over the next few months more than 137,000 Pennsylvanians still in PCO plans will be shifted into HealthChoices plans in stages with completion expected by … Read More
The Pennsylvania Health Law Project has published its February newsletter. This edition features articles on Medicaid expansion in Pennsylvania; problems posed by Healthy Pennsylvania for individuals who receive drug and alcohol or mental health services and how the state is addressing those problems; and the new, special enrollment period for those who are uninsured to sign up through the federal marketplace and avoid the fine for failing to secure health insurance. The newsletter also lists upcoming state legislative budget hearings that will address health care issues and raises the possibility of the state establishing an Affordable Care Act-authorized “Community First Choice” program, which gives a state access to additional federal matching funds to pay for attendant services for Medicaid beneficiaries … Read More
The Pennsylvania Health Law Project has released its January 2015 newsletter. Among the articles in it are pieces on the launch of the Healthy Pennsylvania Medicaid expansion; an update on the temporary extension of the state’s Select Plan for Women; information on how Medicaid recipients who believe they need the state’s new Medicaid “Healthy Plus” benefits package can seek that enhanced coverage; and news on who should consider shifting from a health insurance plan purchased on the federal marketplace to Medicaid. Find the newsletter here.
A flaw in the implementation of Pennsylvania’s Medicaid expansion has left many of the state’s Medicaid beneficiaries with no coverage for the treatment of their drug and alcohol problems – and some providers without payment for some care they have delivered. Under the Healthy Pennsylvania Medicaid expansion program, beneficiaries with extensive health problems, like drug and alcohol issues, were supposed to be directed into the state’s “Healthy Plus” Medicaid benefits package, which covers services that address such problems. Instead, many were places in private, state-approved insurance plans for Medicaid beneficiaries, which do not cover those services. State officials are aware of the problem and say they will soon have a plan to fix it. Learn more about this glitch in … Read More
With the inauguration of a new governor and the start of a new legislative session, the Safety-Net Association of Pennsylvania (SNAP) has prepared a series of four papers for leaders of the new Wolf administration and legislative and committee leaders and staff. The third of those four papers presents eight principles SNAP believes state officials should follow if they choose to abandon the Healthy Pennsylvania model of Medicaid expansion in favor of a more traditional approach to expanding the state’s Medicaid expansion. Those eight principles are: communicate changes effectively to the provider community ensure beneficiaries’ continuity of coverage and continuity of care ensure the adequacy of provider networks simplify beneficiary and provider enrollment preserve vital supplemental payments to safety-net hospitals … Read More
The Pennsylvania Department of Human Services has published materials describing Medicaid benefits under the state’s Healthy Pennsylvania Medicaid expansion. A Medical Assistance Bulletin (#99-15-02) describing the “Interim Healthy Benefit Plan” can be found here and tables comparing the benefits packages under the “Healthy” (low risk), “Healthy Plus” (high risk), and Private Coverage Option plans (PCO) can be found here.
It appears some people may be having trouble taking advantage of Pennsylvania’s “Healthy Pennsylvania” Medicaid expansion. The Pittsburgh Post-Gazette reports that there is a backlog in processing applications, some people who are eligible to participate are getting rejected for coverage, and some who need drug and alcohol treatment services have been placed in plans that do not provide such coverage. The state has acknowledged the problem with drug and alcohol coverage but notes that processing applications can take up to 45 days. So far, the state estimates that 150,000 Pennsylvania households have applied for Medicaid coverage since the enrollment period started on December 1. To learn more about the challenges Pennsylvania’s Medicaid expansion is encountering, see this Pittsburgh Post-Gazette article.
The Pennsylvania Health Law Project has released its latest newsletter. The December edition includes articles about Medicaid benefits under Healthy Pennsylvania; the eligibility criteria for Medicaid; the continuation of the state’s General Assistance program for selected immigrants; and the process for some Pennsylvanians currently insured through the federal insurance marketplace to shift to Medicaid coverage instead. Find the newsletter here.