Affordable Care Act likely to end CHIP
HARRISBURG — Tens of thousands of Pennsylvania children could move from the state's low-income insurance program to Medicaid based on a decision by federal regulators, the Corbett administration said on Tuesday.
“We're not surprised they made that decision,” said Senate Minority Leader Jay Costa, D-Forest Hills. “The Affordable Care Act says explicitly you have to do that.”
Gov. Tom Corbett sought to keep the state's Children's Health Insurance Program, known as CHIP, intact under the federal government's health care law. Federal regulators did not grant that exception, meaning more than 50,000 children could be placed under Medicaid, said Roseanne Placey, spokeswoman for the state Insurance Department. More than 180,000 children are enrolled in CHIP.
Medicaid is the federal insurance program for low-income people. Pennsylvania, under the late Democratic Gov. Robert Casey, was the first state to establish a program for uninsured children.
Corbett's top insurance regulator, Michael Consedine, said the federal response is disappointing. He said the administration will explore options suggested by Health and Human Services Secretary Kathleen Sebelius, such as a phased-in transition.
The requirement takes effect on Jan. 1.
Kids enrolled in CHIP who need extensive medical care will move into Medicaid, Placey said. Medicaid provides broader benefits than the state program, she said, but changing programs means many no longer will be able to see the same provider. Some doctors do not want to participate in Medicaid, officials said.
“We anticipate there could be disruptions in relationships with providers,” Placey said.
A survey in January found CHIP parents rated satisfaction with their child's personal doctor at 8 or higher on a scale of 0 to 10. Specialist care was rated the same, Placey said.
“I know that a lot of our families have children on CHIP now. We'll have to wait and see how it plays out,” said Carolyn Pschirer, director of services for North Hills Community Outreach. “Personally, I think that every child should be insured. Will every child now under CHIP continue to be insured? I don't know. That's my concern.”
Many states prepared for the transition by ensuring Medicaid coverage for older children whose families earn up to 133 percent of the federal poverty level, Sebelius said.
Sebelius said the move will simplify coverage for low-income families. Advocates for the poor say children are better off under Medicaid.
The decision comes as Corbett attempts to negotiate with Health and Human Services on overall provisions of the health care act.
“We are continuing conversations with the federal government, specifically around the governor's interest in instituting common-sense reforms into the Medicaid program,” said Corbett spokeswoman Christine Cronkright.
Corbett has refused to expand the Medicaid program, an option for states under a 2012 Supreme Court decision on the federal law. The expansion would add about 800,000 people to Medicaid. Corbett and some Republican lawmakers insist Pennsylvania taxpayers can't afford the expansion.
The governor is expected to announce his idea soon for a revised Medicaid program in Pennsylvania.
He would like reforms “such as a work-search requirement” to help “transition those on public assistance into the workforce,” Cronkright said.
Corbett wants “a reasonable premium or co-pays, where appropriate, for able-bodied Pennsylvanians on Medicaid,” she said. “If we can achieve reforms to our current program, we believe we can increase access to health care options for more Pennsylvanians.”
Staff writer Michael Hasch and The Associated Press contributed to this report. Brad Bumsted is Trib Total Media's state Capitol writer. He can be reached at 717-787-1405 or firstname.lastname@example.org.