Key deadlines for Obamacare are creeping closer, and consumer health advocates want specifics on how it’s all going to work.
In Pennsylvania, the federal government will run the insurance marketplace where individuals can shop for — and buy — health coverage. A huge data hub is in the works to determine if applicants will be eligible for tax breaks or, alternatively, if they qualify for Medicaid.
So, the big question is: Do the feds get to tell Pennsylvania who the state must accept into Medicaid?
Historically, the states — not the federal government — make that call.
Ann Bacharach with the Pennsylvania Health Law Project says so far the Corbett administration has opted to maintain control over who is enrolled in Medicaid.
“They’re worried that the exchange may make too many people eligible,” Bacharach said. “But the advocates’ concern — very much — is that this will slow down the process, make it more burdensome for those folks who are Medicaid- or CHIP-eligible. They may have to provide additional proof or wait an additional period of time.”
So far, Pennsylvania has declined to expand its Medicaid program.
But experts say, as 2014 draws closer, increased advertising about the health law will alert more people that they are required to have coverage and increase the number of those queuing up for health benefits.
“Does the state have the capacity to manage those requests? People want to know what is the criteria, and what is the decision-making process for the state going forward,” said Rob Simmons, director of the public health program at the Jefferson University School of Population Health.
Today, Medicaid eligibility decisions are made at county offices across Pennsylvania. Last year, consumer advocates sharply criticized the state Department of Public Welfare and said those offices were woefully understaffed.