Corbett Administration’s Alternative Plan to Medicaid Expansion Now Under Federal Review

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The Corbett administration has put together an alternative plan to the Affordable Care Act’s (ACA) Medicaid expansion. The plan, dubbed Healthy Pennsylvania, is now being reviewed by the Centers for Medicare and Medicaid Services (CMS), which is the federal agency that administers Medicare and works with the states to administer Medicaid. Until April 11 at 6am, the agency is accepting public comments before deciding to approve the plan or not.

A cursory look at the over 350 comments — as of April 3 — shows a strong negative reaction to the plan’s job-search requirement, which mandated that an unemployed Medicaid applicant take specific steps to find employment.This requirement was removed from the latest version of the plan and made into a voluntary program that offers discounts in exchange for participation. There were also a number of responses strongly supporting the plan or at least expressing a lack of support for the ACA.

The application for the plan, submitted by the PA Department of Welfare, claims that it will cover 500,000 Pennsylvanians by using the expanded Medicaid funds to help pay for private insurance options. Depending on income and a number of other factors, such as participation in other assistance programs, childless adults and couples may have to pay some of the premium on their health care plan. In addition, the Corbett administration is still pushing for a waiver from the federal government to allow some kind of job-search requirement that would take effect on the second year of the program.

The state is able to develop its own plan because of the 2012 Supreme Court decision that made accepting the Medicaid expansion optional to states. But unlike some other Republican governors — 21 states have refused — Corbett is not outright denying the expansion. Instead, his administration is asking the federal government permission to use the funding for its own plan. Iowa and Arkansas also submitted plans to use the Medicaid funds to help purchase private health options. Both were accepted.

In the application given to CMS, the Corbett administration claims that the funds are absolutely necessary to the success of the plan:

“Our ability to provide quality health care coverage to low income Pennsylvanians will rely on a commitment from the federal government to maintain, without change or disruption, all the existing funding sources.This Demonstration request is also predicated on enhanced federal funding under the Affordable Care Act.”

Pennsylvania will not go through with the current plan if the funds are not available, according to the application.

The Corbett administration has criticized the Medicaid expansion as a “one size fits all” approach. Other PA organizations and advocacy groups, including the Pennsylvania Health Law Project and Community Legal Services (CLS), have argued that simply expanding Medicaid as outlined in the ACA would serve the state best.

CLS’s criticism goes further. The Philadelphia-based nonprofit legal service claims in a report put out last month that the Healthy Pennsylvania plan will slash Medicaid benefits for 1.1 million people, half of the 2.2 million currently using Medicaid in the state. CLS has also stressed that charging a premium to Medicaid users, however reduced, will lead to loss of coverage and unmet health needs.

Corbett meanwhile has expressed his frustration with the federal review process, according to the Inquirer. He has even considered “pulling the plug” on the plan if it is not approved soon.

To leave a comment, visit Medicaid.gov.The Centers for Medicare and Medicaid will approve or deny the plan after the public comment period.  Comments can also be sent to RA-PWHealthyPA@pa.gov or mailed to 625 Forster Street, Harrisburg, PA 17120.

The full application for the Healthy Pennsylvania plan is available below. This document also includes a letter from Governor Corbett about compromising on the job-search requirement: