Pennsylvania Plans for Medicaid Expansion
The Medicaid expansion is 100 percent federally funded for the years 2014 through 2016.
- On February 9, 2015, Governor of Pennsylvania, Tom Wolf announced that the State would be transitioning to a Medicaid expansion plan. This plan will replace the state’s previous low-risk “Healthy” option which was the cause of multiple problems within the state’s healthcare industry.
“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,” said Wolfin the announcement. “Our approach will alleviate confusion, remove unnecessary red tape, and streamline the system so that people can see a doctor when they are sick and healthcare professionals have more time to concentrate on providing quality care.”
The states previous Healthy PA coverage caused problems that ranged from providers being unable to provide their patients with much needed care, patients being placed in incorrect coverage plans and general confusion.
According to an article in The Inquirer written by Robert Calandra, the rollout of the program caused multiple problems for centers such as Gaudenzia, the drug and alcohol treatment center. A system error enrolled thousands of patients throughout the state in private insurance instead of the Healthy Plus Medicaid program. These private plans often didn’t cover treatment for addiction, and providers were unable to treat patients in need of urgent care.
The article also indicated that the mix up with coverage puts a financial burden on providers. Deb Beck, president of the statewide treatment coalition, the Drug and Alcohol Service Providers Organization of Pennsylvania, told The Inquirer that larger programs have been able to treat patients without payment; however smaller programs are more likely to suffer financially.
Other problems the state faced through the Healthy PA program include:
- Application backlogs for patients to receive coverage because the Department of Human Services (DHS) requested unnecessary information.
- Special populations (e.g., women) were put into the private coverage option (PCO) when they should have been placed in a different plan. This caused approximately 90,000 women to be at risk of losing coverage.
The announcement from Wolf indicated that the commonwealth of PA is working with DHS to switch patients accidentally enrolled in the PCO to the Adult package, which will provide streamlined coverage to the new Medicaid expansion and allow providers to treat patients as needed.
The Medicaid expansion is 100 percent federally funded for the years 2014 through 2016.
“We are committed to ensuring an orderly and efficient transition for every Pennsylvanian receiving health care coverage through the commonwealth,” said DHS Acting Secretary Ted Dallas in the announcement. “We are already at work making changes to our eligibility systems that will take effect this spring. This will enable us to transition individuals participating in the General Assistance and SelectPlan programs to the new health plan.”
