Pennsylvania pushing Medicaid plan to D.C.

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HARRISBURG -- Months after outlining a controversial proposal to overhaul the state's Medicaid program, officials from Gov. Tom Corbett's administration said Wednesday they are submitting their plan to the federal government -- though it has been somewhat modified after seven public hearings around the state.

However, the "Healthy PA" plan still retains some of what critics say could be hurdles to federal approval: work search requirements for applicants and premiums for some low-income Medicaid enrollees. To make those changes, the state needs a waiver from the federal government, and that's why the state is submitting a waiver application.

Democrats and many advocacy groups have blasted Mr. Corbett's proposal, and said simply that allowing the state to participate in an expansion of Medicaid would take advantage of federal funds and provide health care for more people, sooner.

Federal officials have 15 days to review the state's plan, followed by a 30-day public comment period.

"We are asking for a timely review and approval," Beverly Mackereth, secretary of public welfare, said Wednesday, saying state officials have been in conversation with the federal government since last April.

If approved, state officials don't anticipate the changes taking effect until January 2015.

The work search requirement will likely be the most problematic for federal regulators, Ms. Mackereth said.

"We know it is a stretch for the federal government," she said.

The proposal being submitted also would increase some benefits -- such as primary and preventative care, mental health services, lab services, and drug and alcohol treatment -- beyond what the administration had originally proposed. Other changes from the administration's first proposal scale back and delay the proposed premiums for some patients.

"We listened and we heard what people were saying" at the public meetings, Ms. Mackereth said.

The Hospital & Healthsystem Association of Pennsylvania and the Pennsylvania Medical Society support the plan, according to statements from both groups.

Medicaid is a huge cost driver in the state budget, with 1 in 6 Pennsylvanians enrolled in the program. Medicaid accounts for about 27 percent of the commonwealth's entire general fund budget, though Ms. Mackereth acknowledged Wednesday much of the growth in costs comes from long-term care, which is not addressed in the plan.

"We know that we need to address this," she said Wednesday.

The entire application can be viewed online:

Kate Giammarise: 717-787-4254 or or on Twitter @KateGiammarise.

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