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Corbett would reform Medicaid, cover uninsured through private plans

Tom Corbett: Philip G. Pavely | Tribune-Review
Gov.

What's at stake

• Provide coverage to 520,000 people by purchasing private insurance with federal money. Those eligible would earn below $15,870 for an individual and $32,500 for a family of four.

• Consolidate 14 adult benefit plans into two commercial-style packages for existing Medicaid recipients.

• Eliminate most co-pays under Medicaid.

• Impose monthly premiums up to $25 for recipients.

• Keep “medically frail” patients, such as someone with bipolar disorder, on Medicaid.

• Allow individuals to reduce monthly premiums by taking part in wellness programs and actively engaging in job searches.

Source: Corbett administration

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By Brad Bumsted and Alex Nixon
Monday, Sept. 16, 2013, 4:54 p.m.
 

HARRISBURG — Republican Gov. Tom Corbett on Monday proposed major changes to Medicaid, the government health care program for the poor, and suggested using federal money from Obamacare to buy private insurance for 520,000 uninsured Pennsylvanians.

“We must align Medicaid benefits similar to those of working insured Pennsylvanians,” he said.

His plan is part of the administration's formal response to the federal government on whether Pennsylvania will expand Medicaid under the Affordable Care Act.

A Supreme Court ruling last year upheld the law but gave states the option of expanding the insurance program for low-income people.

At Harrisburg Hospital, Corbett bashed Obamacare but laid out a plan to accept federal money to provide health care coverage for the poor.

Corbett, a candidate for re-election next year, tried to strike a balance between his conservative roots and demands by hospital executives and lawmakers to help the poor. As attorney general, Corbett joined the lawsuit that resulted in the Supreme Court ruling.

He called Obamacare “an unprecedented tax on Americans” that will “escalate health care costs for families and job creators.”

Corbett's plan requires “able-bodied” unemployed Medicaid recipients to seek job training and employment. It eliminates co-pays and charges recipients monthly premiums of up to $25.

The proposal requires approval from the Obama administration. Four other states are pursuing alternatives to Medicaid expansion.

Under Corbett's plan, working people earning less than 138 percent of the poverty level and not in the Medicaid program would go to the online insurance marketplace that the law established to buy coverage the government would pay for. To be eligible, a single person must earn less than $15,870 or $32,500 for a family of four. People above those income levels qualify for subsidies to offset some cost.

Guy Anthony, 61, of Bucks County is a contract worker who makes too much to qualify for Medicaid but not enough to gain government subsidies, he said. Years of untreated high blood pressure brought on his congestive heart failure, he said. He hopes Corbett's proposal will give him access to insurance.

“Being uninsured nearly cost me my life,” he said.

Pennsylvania and the federal government spend $19 billion annually on Medicaid to insure 2.2 million Pennsylvanians. The state spends 34 percent more than the national average on Medicaid, Corbett said. His plan would consolidate 14 benefit packages into two for Medicaid beneficiaries.

Medicaid insures one in six people in Pennsylvania. Rather than accept Obamacare provisions, Corbett said he would take advantage of flexibility the Supreme Court granted and craft a plan. His administration began negotiating with the federal Department of Health and Human Services in January.

Corbett said his plan works to ensure everyone access to health care: “It's a Pennsylvania-based plan that is based on common-sense reforms, creates real health care choices, reduces government bureaucracy and provides a pathway to independence.”

Reaction to the plan came swiftly.

“We commend Gov. Corbett for refusing to take the politically expedient route of putting more people into Medicaid without first reforming it,” said Matthew Brouillette, president and CEO of the conservative Commonwealth Foundation. “Simply giving more people ‘coverage' is not the same as giving them ‘care.' ”

But Brouillette said the foundation cannot support establishing a “taxpayer-subsidized program for hundreds of thousands of new participants.”

Marc Eisenstein, state Democratic Party spokesman, said Corbett delayed addressing Medicaid for months and then proposed “a weak half-measure that will continue to make it harder for Pennsylvanians to get the care they need while giving a handout to insurance companies.”

Eisenstein said Corbett cut funding for county health services and eliminated the adultBasic program, “kicking thousands of Pennsylvanians off their health insurance.”

Senate Democratic leaders said they welcomed a discussion on the issue.

UPMC Health Plan, the second-largest health insurer in Western Pennsylvania, and Highmark, the state's largest insurer, will sell individual health plans on the federal exchange in Pennsylvania. Spokesmen for both companies applauded Corbett's ideas.

But Rep. Dan Frankel, D-Squirrel Hill, expressed caution about any plan outside the traditional Medicaid program: “We'll want to know that the plan doesn't reduce benefits for people in need, or require costly co-payments that prevent low-income workers from getting care when they're sick.”

Brad Bumsted and Alex Nixon are Trib Total Media staff writers. Reach Bumsted at 717-787-1405 or bbumsted@tribweb.com. Reach Nixon at 412-320-7928 or anixon@tribweb.com.

 

 
 


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