Medicaid enrollees in Pa. could see benefit cuts

    Policy analysts are staying tuned for additional changes to Medicaid benefits for current enrollees in Pennsylvania.

    Federal officials set aside Gov. Tom Corbett’s proposal to curb Medicaid benefits when they considered his overall plan to expand health care coverage for the working poor by using private insurance plans. But the changes still under negotiation could limit things including wheelchairs, home care visits, and physical therapy for Medicaid enrollees.

    Joan Alker, executive director of the Georgetown University Center for Children and Families, said federal law for Medicaid allows great flexibility to match subsidized benefits to commercial plans.

    “So it looks like he’s going to try to bring down the benefit package for your current very low-income parents to the stingiest level in the country,” Alker said of Corbett.

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    The federal government approved Corbett’s alternative Medicaid expansion plan last week. His office touted it as a triumph of entitlement reform.

    But Alker said the approved waiver shows the Corbett administration was serious about expanding Medicaid coverage.

    “In general, there were a lot of key issues that the governor did compromise on,” she said.

    Alker added that the most touted element of the waiver – using federal money to subsidize private insurance coverage – isn’t largely different from Pennsylvania’s existing Medicaid program, which already uses private options to deliver services.

    “The governor didn’t even need a waiver to contract with managed care companies to deliver the services,” Alker said. “That’s sort of rhetorical sleight of the hand, frankly.”

    The plan includes mandatory premiums for higher-income earners receiving the health care benefit, but administration officials point out that recipients can discount premiums by getting job-training or going for regular check-ups.

    Alker said such a provision has been approved in other states’ Medicaid waivers, but she said it’s a problem for states looking to expand coverage to as many people as possible.

    “We have a lot of research to suggest that when low-income people are required to pay premiums, it will depress enrollment,” Alker said. “There’s no question about that.”

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