Wolf moves toward Medicaid expansion under Obamacare
HARRISBURG — In a major shift from the path set by his GOP predecessor, Democratic Gov. Tom Wolf on Monday moved toward full Medicaid expansion, saying his plan provides poor people with greater access to insurance.
Wolf intends to repeal by fall the Healthy PA program begun by former Gov. Tom Corbett and approved by the federal government in August, according to the governor's office.
The administration said switching thousands of people from private insurance plans under Healthy PA to federal coverage under Medicaid should not cost the state more money now, although it did not release total cost projections. Premiums for enrolled families will no longer take effect, and plans under the Corbett-era program will no longer be available starting in spring, administration officials said.
“Today is the first step toward simplifying a complicated process and ensuring hundreds of thousands of Pennsylvanians have greater access to the health insurance they need,” Wolf said in a statement. He said his approach will “alleviate confusion, remove unnecessary red tape and streamline the system” for doctors and patients.
Still, Republican lawmakers pounced on what they called a lack of specifics for the plan, which could affect about 600,000 low-income Pennsylvanians who were eligible for Healthy PA plans that took effect Jan. 1. The administration did not specify how co-pays or total enrollment might change.
“What is the impact on the budget?” House Republican Whip Bryan Cutler of Lancaster County asked. “If we simply do an expansion of Medicaid, who's on the hook for that? We have a long history of the federal government not doing things they promised to do.”
Senate Majority Leader Jake Corman said the state has poured about $95 million for information technology and set-up into Healthy PA.
“That's significant for a program that never had an opportunity to be judged on its own merits. Rather, the program is being scrapped due to ideology, and taxpayers will have to incur the costs of set-up for yet another system,” said Corman, a Centre County Republican.
Department of Human Services spokeswoman Kait Gillis said “a small cost” increase is possible under the change but did not specify how much. She and Wolf spokesman Jeff Sheridan said the federal government will pay the cost of the Medicaid expansion through 2016, following terms of the federal Affordable Care Act.
The state's share will grow incrementally to 10 percent by 2020.
Corbett resisted for almost two years the Medicaid growth driven by President Obama's signature health care law, arguing that strings attached to the federal plan would make it expensive to state taxpayers in the long run.
Instead, Corbett forged the Healthy PA hybrid to direct federal money to private insurers to cover Pennsylvanians who earn too much to qualify for traditional Medicaid but less than 138 percent of the federal poverty level, or about $32,900 for a family of four.
The federal Department of Health and Human Services approved the idea after lengthy negotiations. Critics said Healthy PA faltered fast, limiting key services for some low-income families by racking up savings that could have topped $4 billion over eight years.
“A lot of folks haven't heard back on applications they submitted almost two months ago. Folks are seeing applications denied when they shouldn't be. There's a whole host of problems that keep popping up,” said Antoinette Kraus, director of the Pennsylvania Health Access Network.
She said the statewide coalition fields about 100 calls a day from people who need help applying for or dealing with Healthy PA plans. A total of about 2.3 million Pennsylvanians receive medical assistance.
“Millions of Pennsylvanians will be able to get the health care they need because Gov. Wolf recognizes that the expansion of Medicaid as offered in the Affordable Care Act passed in 2009 is the smartest, most efficient, most cost-effective way to get affordable care” for state residents, said Michael Morrill, executive director of Harrisburg-based Keystone Progress.
Other observers disagreed, calling the federal program ineffective and wasteful and arguing that Wolf's plan will open the door to misuse.
“Our poorest residents are subject to substandard care under Medicaid. Adding even more able-bodied adults to a program intended to serve our poorest residents will only increase the strain on the system and exacerbate the existing problems,” said Beth Anne Mumford, state director of Americans for Prosperity. “We need to reform Medicaid to offer better outcomes at a lower cost, not add more people to the system.”
Several participating health insurers in Healthy PA, including Downtown-based UPMC Health Plan and Gateway Health Plan, voiced willingness to work with Wolf on the transition. Many will probably retain Healthy PA participants if those families switch to Medicaid-financed plans administered through the private sector, said Denis Lukes, vice president of the Hospital Council of Western Pennsylvania.
Gillis said the state is working with insurers on a transition process. She said the 156,000 people enrolled in Healthy PA private coverage options will not be subject to immediate changes, and coverage applications will continue.
The governor's office does not need legislative approval to put the new plan in place, providing that HHS approves. But the Republican-controlled Legislature would have the power to block implementation of Wolf's plan.
Governors can veto bills but the Legislature can override legislation with two-thirds support.
“In the long term, we are concerned that consumers are losing the ability to choose a program that best fits their needs in exchange for the one-size-fits-all Obamacare,” Corman said. “With this action, we cede all control to the federal government, including the program costs or lack thereof.”