Corbett to submit waiver to expand Medicaid coverage

The Corbett administration said today it will submit a waiver sometime after mid-January seeking to use billions in federal Medicaid funds to provide health insurance for hundreds of thousands of uninsured Pennsylvanians.

The details of the proposal will be made public Friday when the plan is released in the weekly Pennsylvania Bulletin.

In a briefing with reporters, state officials said they will submit the proposal following a series of hearings across the state but gave no projected timetable for its implementation.

"It is the next step to provide increased access to health care for the uninsured,." said Todd Shamash, Corbett's deputy chief of staff. "We said we were going to do it and now we are delivering on it."

The news comes almost three months after Corbett announced his plan to make sweeping changes to the state's Medicaid program and insure coverage for some 500,000 people using Affordable Care Funds to cover costs through private insurance system without expanding the Medicaid rolls.

"This is a comprehensive solution to improve health outcomes, these are changes we all want to see work," said Bev Mackereth, secretary of the Department of Public Welfare.

The proposal for "Healthy PA" is similar to one designed by Arkansas that received approval from federal government, but has several elements that could pose obstacles: requirements that recipients cover a "modest" premium and that working age, able-bodied recipients be engaged in a job search in order to qualify.

Pennsylvania would be the first state to require a job search to qualify for Medicaid coverage.

The premium for new enrollees would be set up on a sliding scale depending on income and a recipient could get a reduced rate for meeting certain "health goals," such as a yearly physical, and reductions if one is working, even part time.

For instance for someone making up to 100 percent of the federal poverty the rate would be $13 a month but that could be reduced to $6.50 if certain health goals are met.  Those with the lowest incomes, along with pregnant women, would be exempt from the premium.

All Medicaid recipients would be required to participate in a health assessment when their annual eligibility review comes up.

"Nothing in Medicaid right now promotes seeing a family doctor," said Shamash.

Twenty-five states - including all of the states surrounding Pennsylvania - plus the District of Columbia - are moving forward with Medicaid expansion starting Jan. 1, while 25 other states have said they will not expand Medicaid programs.

There is no deadline for states but the clock starts ticking January 1 when federal money begins flowing to the states.

Under the Affordable Care Act, the federal government covers the full cost of newly eligible Medicaid beneficiaries for the first three years and not less than 90 percent of the cost in the years thereafter. It expands coverage to individuals and families earning up to 138 percent of the federal poverty level, or up to $15,800 for an individual or $32,400 a year for a family of four.

The Philadelphia hearing will be held at the Convention Center on Jan. 3 from 10 a.m. to 1 p.m.

Once the proposal is submitted to the department of Health and Human Services another 30 day public comment period begins on the federal side.

State officials said they will seek expedited approval but could not project when uninsured low-income  Pennsylvanians would be able to sign up for health coverage.

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