The federal government has approved Gov. Tom Corbett’s alternative to Medicaid expansion, the culmination of a roughly year-long negotiation to use federal money to subsidize private insurance plans for low-income Pennsylvanians.
The Corbett administration estimates more than 600,000 people are eligible.
Jennifer Branstetter, the governor’s policy director, said the approved alternative does not represent an expansion of Medicaid as authorized by the federal Affordable Care Act.
“Gov. Corbett made it very clear from the beginning this was about reform first and increased access to Pennsylvania’s working poor second,” Branstetter said. “The whole premise of applying for a waiver is the fact that we wanted to do something different from Medicaid expansion. If we wanted to expand Medicaid, we could have flipped that switch.”
The governor’s office touted Thursday the approved changes to the state’s Medicaid program, including a requirement to pay monthly premiums for anyone at 100 percent of the federal poverty level. That’s a single person making about $12,000 a year, or a family of four living on $24,000 a year.
The premiums would be 2 percent of household income and begin in 2016. They would also apply to people enrolled in the newly available private plans.
Anyone who fails to make their premiums for three months in a row would be dropped from coverage. People could cut their premiums by up to 50 percent by engaging in job-search or job-training activities, though neither is required to receive coverage.
“You participate in job-training opportunities, we’re going to reduce your premiums. It’s encouraging personal responsibility, healthy behavior,” Branstetter said.
About 55,000 people now enrolled in Pennsylvania’s Medicaid program will become ineligible as of next year, and must switch to private plans for coverage.
Enrollment in the private health care plans is slated to begin in December. Coverage is expected to begin in January.
The administration expects the plan to save the commonwealth $125 million this fiscal year, and $600 million next fiscal year.
Members of the Corbett administration said they would not need legislative approval to implement the federally approved HealthyPA plan. They could not speculate about whether the plan would be jeopardized by a change in the governor’s office.
“I think it would be unfortunate for whoever’s in office January to undo this,” said Branstetter.
Corbett is up for re-election in November. His Democratic opponent, Tom Wolf, supports Medicaid expansion.
HealthyPA was officially proposed by the administration in September.