Gov. Tom Corbett has set in motion big changes to Pennsylvania’s Medicaid program. But Tom Wolf’s election Tuesday puts those changes into limbo.
Notices have been sent out to some 800,000 current enrollees about potential changes to their benefits come January, placing them in either a “high” or “low” risk category of coverage. Individuals in the so-called “Medicaid gap,” typically low-income adults who make too little to qualify for subsidies Obamacare but too much to qualify for Medicaid, will soon be eligible for Corbett’s alternative, subsidized private insurance.
“We need a medical insurance program that’s designed for Pennsylvania,” Corbett said last year, when he submitted the proposal. “One size does not fit all.”
Corbett generally won that federal approval for his Healthy PA medicaid waiver plan in August. Instead of drawing down federal funds to directly expand Medicaid to hundreds of thousands of other low income Pennsylvanians, the state is using that money to essentially subsidize private coverage.
People can start signing up December 1. Coverage begins January 1 and Wolf takes office January 20.
Wolf campaigned on replacing Corbett’s plan with an expanded, traditional Medicaid. A statement Thursday from Jeffrey Sheridan, with Tom Wolf’s campaign, clarifies Wolf’s position:
“Tom will review the law and work with the appropriate parties to expand Medicaid. Expanding Medicaid as it is intended under the law will provide accessible health care for hundreds of thousands of Pennsylvanians, reduce unnecessary bureaucracy, and provide billions for the state’s economy.”
Antoinette Kraus of the Pennsylvania Health Access Network, a consumer advocacy group that strongly supports a traditional expansion, says Wolf has the administrative authority to reverse Corbett’s plan once he’s in power. Transitioning from the private plans over to traditional Medicaid wouldn’t be too complicated she says.
“A lot of the structure that we are seeing is similar to a [traditional] medicaid expansion,” she said. “I think where the problems arise is that we’re drastically changing benefits for our current medicaid recipients.”
The Centers for Medicare and Medicaid have yet to give final approval to those benefits changes to current enrollees, according to Kraus, even as the state has sent out notices. She says reversing those changes, if they were to take effect as planned in January, is possible but would be more complicated, technically.
Even if Wolf wants to kill Healthy PA, “he can’t snap his fingers…waive a magic wand and make Healthy PA go away,” said Rob Field Rob Field, a health law professor at Drexel University. Tuesday’s elections strengthened Republican control of the Pennsylvania legislature, and Wolf can’t ignore that.
“He can do it [an expansion] on his own with the permission of the Obama administration, which I don’t doubt they would give,” says Field. “But the republican legislature may not like this idea, and they could use funding and other techniques to try and gum up the works.”
Field says Wolf would still be able to unravel it, “but it will take some doing.”
The expanded coverage is bankrolled by billions of dollars from Washington. It’s part of the Affordable Care Act.