Health insurance is complicated. When you're struggling to make ends meet, that means not getting coverage. When Governor Corbett released his Healthy PA plan as an "alternative" to a traditional expansion of the Medicaid program, it was laced with complexity. His determination to make it different from the existing Medicaid program meant creating new private insurance plans. These ended up being run by many of the same companies that were already administering the Medicaid program but now would have two entirely different sets of plans.
It also meant complex health screening forms – some requiring the help of a doctor to fill out – and eventually the added burden of new monthly premiums. They were intended to promote personal responsibility, but in reality they would generate very little new revenue. In fact, the cost to collect the premiums would wash out most of those meager revenue gains. That is, unless the real goal was to save money by cutting enrollment. Other states that have enacted premiums in their Medicaid programs have seen big drops in enrollment. A decade ago, Oregon lost about half of its Medicaid enrollees when its program started requiring monthly premiums and locked people out for non-payment.
On Monday, Governor Wolf announced he was taking the first step to scrap Governor Corbett's complicated Healthy PA plan. Hopefully, this is the first step toward doing what the Affordable Care Act was intended to do – simplify Medicaid and get people covered. Since the launch of Healthy PA, the complexity has created enrollment backlogs and confusion. Some applicants have been improperly rejected.
The ACA was intended to shift Medicaid away from complex eligibility requirements and toward a simple, income-based calculation. Healthy PA got in the way of that simplicity.
Governor Wolf should move swiftly to further simplify the program and make enrollment and re-enrollment as easy as possible. That would help many low-income Pennsylvanians struggling to make ends meet get and stay covered and also decrease the state bureaucracy to process applications. In the meantime, consumers who are caught in the middle need to be protected.
Health insurance is indeed complicated – even for highly educated individuals. It's even more complicated when you're living in or near poverty and the program you just enrolled in is being dismantled. The Wolf Administration will need to be vigilant to protect consumers in this year of transition to make sure they get enrolled, don't lose coverage once they have it, and can access the care they need. If he does, all Pennsylvanians will be better off.
Editor's Note: Cross-Posted on the Voices@LDI blog of the Leonard Davis Institute of Health Economics of the University of Pennsylvania.
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