Federal approval of Gov. Tom Corbett’s Healthy PA plan is good news for 600,000 uninsured Pennsylvanians, but it is tempered by how long it took for the relief to come and questions about how the changes will affect existing Medicaid clients.
Yes, it would have been quicker and easier if Mr. Corbett had agreed to a simple expansion of Medicaid, provided for under the Affordable Care Act — and enacted in all neighboring states — but that wasn’t going to happen with such an adamant opponent of Obamacare in the governor’s office. At least Mr. Corbett abandoned a flat-out “no” in favor of some accommodation.
His plan will mean that uninsured, working state residents who earn too much money to qualify for Medicaid — up to $16,105 for individuals and $32,913 for a family of four, for instance — will become eligible for subsidies to purchase private insurance. That’s bound to help them.
But improving access for the uninsured is only half of the governor’s plan; his twin goal is reforming the existing Medicaid model to pay for the expansion and keep a lid on costs, which account for 29 percent of the state’s General Fund budget.
Big changes are planned for the 2 million people already enrolled in Medicaid. Their 14 plan options will be trimmed to two — high- or low-risk. Individuals will have to pay a monthly premium, 2 percent of their earnings. The administration’s theory is that people will have a greater incentive to get preventive care if they’re contributing financially, and discounts will be available to those who enroll for job training, go for wellness visits and engage in other healthy activities.
Advocates for poor Pennsylvanians, though, are worried that the premiums will be a burden and that expensive services may be off-limits to some enrollees, which administration officials rebut, saying people who need higher-level care will get it because they’ll be in the high-risk coverage plan.
There’s a lot more to learn about the impact Healthy PA will have. Here’s hoping that what seems like a step in the right direction doesn’t turn out to be a misstep.