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Corbett's alternative to Medicaid expansion under the microscope

Who's covered

Gov. Tom Corbett's Healthy PA plan would give a private market option for health care coverage for 520,000 Pennsylvanians by using federal Medicaid dollars to buy insurance on the health care insurance exchange. The coverage would apply to those earning up to 133 percent of the federal poverty level, about $15,500 for an individual who is not eligible for Medicaid.

Friday, April 11, 2014, 10:34 p.m.
 

After hundreds of consumers, doctors and interested parties sounded off online, the state and federal governments will begin “formal negotiations” on whether about 520,000 residents will get health care coverage under Gov. Tom Corbett's “Healthy Pennsylvania” proposal.

The plan is Corbett's suggested alternative, or waiver, to a Medicaid expansion under the Affordable Care Act. The governor seeks to create a private market option instead of an expansion for newly eligible low-income residents. The proposal also reforms current Medicaid benefits.

A federal public comment period on the proposal closed Friday. The online forum, operated by the Centers for Medicare and Medicaid Services, garnered 789 responses.

“Once CMS has completed their public comment period, they will advise of additional areas for discussion and formal negotiation on the waiver will begin,” said Kait Gillis, state Department of Public Welfare spokeswoman, in a statement to the Tribune-Review.

Federal modification or approval of the waiver application does not have a deadline, Gillis said. The state applied for a waiver in February.

Talks between the federal and state agencies have continued since Corbett announced the plan in September.

Corbett's 2014-15 budget proposal includes $125 million in savings predicated on federal approval of the waiver. The state's fiscal year begins on July 1.

CMS officials estimate it will take about two weeks to review the public feedback.

Largely remaining anonymous, some commenters called the plan “terrible” and “mean-spirited.” Self-identified chiropractors chimed in to protest proposed cuts for their services.

Others voiced support for the limits on benefits as “a good, sustainable solution.” According to the Corbett administration, Pennsylvania spends 27 percent of its budget on Medicaid, which costs state taxpayers and the federal government a combined $19 billion annually.

Antoinette Kraus, director of the Pennsylvania Health Access Network, said the largest concern about Healthy PA is proposed cuts to existing benefits.

“We are asking more than any other state in the country with waivers in the Healthy PA proposal,” she said.

Under the proposal, Medicaid recipients would not be covered for optometrist, podiatrist and chiropractor services. The waiver would reduce unlimited radiology services to six tests a year. Medical supply purchases would be capped at $1,000 or $2,500 a year, depending on the enrollee's overall health.

Jay Pagni, the governor's spokesman, said the goal of Healthy PA is to provide an affordable health care solution.

“We share that common goal” with the federal government, Pagni said. “And we will work through the differences in our approaches to get us to that common goal.”

Melissa Daniels is a Trib Total Media staff writer. Reach her at 412-380-8511.

 

 

 
 


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