If enacted, Republican Gov. Tom Corbett’s Healthy PA Medicaid proposal would repeal a program that provides assistance for low- and middle-income workers with disabilities, many of whom would be forced to pay higher health insurance rates in the commercial marketplace.
The state’s Medical Assistance for Workers with Disabilities program provides medical benefits to more than 33,000 Pennsylvania workers. Participants pay 5 percent of their monthly earnings toward Medicaid premiums in exchange for need-based benefits that might include clinical visits, medical transportation, drug and alcohol treatment, and dental care.
The state estimates it would save about $7 million a year by eliminating the program. Under the Healthy PA plan, most new Medicaid recipients would use federal government subsidies to pay for private insurance plans. Healthy PA would offer “premium assistance” to those earning up to 133 percent of the federal poverty line.
Workers currently are eligible for the Medical Assistance for Workers with Disabilities program if they have less than $10,000 in resources — including retirement savings — and their household income does not exceed 250 percent of the federal poverty level. That means individual beneficiaries can earn up to $29,175 and a household of four can make up to $59,625 this year.
That exceeds the typical financial eligibility threshold of Medicaid because the program was designed to accommodate individuals with disabilities who wish to work.
“For these workers, it can be very rewarding and fulfilling to get a paycheck,” said Steve Christian-Michaels, COO of Family Services of Western Pennsylvania. Jobs can help workers with disabilities better integrate into their communities.
The insurance subsidy is particularly beneficial to persons with disabilities who do not work a full 40-hour week, a common eligibility requirement in order to receive employer-sponsored medical coverage.
Part-time employment is prevalent among workers with disabilities, many of whom do not have the physical or emotional stamina to work full time. According to a survey conducted by the U.S. Bureau of Labor Statistics in 2013, 34 percent of workers with disabilities are employed part time, in contrast with 19 percent of those with no disability.
“[The Medical Assistance for Workers with Disabilities program] is the mechanism that allows part-time workers to maintain insurance,” said Mr. Christian-Michaels.
Under the Corbett administration’s Healthy PA proposal, Medical Assistance for Workers with Disabilities recipients earning between 134 percent and 250 percent of the federal poverty line would lose state-subsidized coverage altogether. Instead, they would rely on federal subsidies through the Affordable Care Act’s health insurance marketplace.
“They will be provided with redesigned benefit packages that are consistent with national standards pertaining to essential health benefits, mental health parity and preventive services,” said Kait Gillis, press secretary of the Pennsylvania Department of Public Welfare. “These services will allow them to maintain their health, remain in a community setting and continue working.”
“These folks can’t earn a living wage and also pay for the supports they need,” said David Gates, a senior attorney with the Pennsylvania Health Law Project in Philadelphia, adding that the repeal of coverage might even provide a systemic disincentive for these workers to exceed the 134 percent line in earnings.
“Healthy PA is based on the assumption that a different population with different needs can get those supports in the marketplace like other individuals,” said Mr. Gates. “That fundamental premise … is flawed.”
The final review of Healthy PA is due to be announced by the Department of Public Welfare within the month.
Rocio Labrador: firstname.lastname@example.org or 412-263-1370.