PHILADELPHIA (AP) – A half-million more low-income Pennsylvanians are in line to get federally funded health insurance after the U.S. Department of Health and Human Services approved the state’s plan to accept Medicaid expansion money under the landmark 2010 federal health care law, officials said Thursday.
The Corbett administration said the federal agency approved a plan that lets private insurers administer Medicaid-funded coverage that adheres to Medicaid’s existing rules. The plan vastly expands a Medicaid program that already covers 2.2 million adults and children in Pennsylvania.
Enrollment in the plan, named Healthy Pennsylvania, is expected to begin Dec. 1 with coverage to start the following Jan. 1.
The Medicaid expansion money became available Jan. 1 of this year, and Corbett was under pressure from hospitals, labor unions, the AARP and advocates for the poor to accept it to cover hundreds of thousands of low-income working adults.
But Republican Gov. Tom Corbett, a critic of President Barack Obama’s signature health care law, refused to accept the money without changes to the Medicaid expansion as it was envisioned by the law. He proposed ways to make the Medicaid coverage more like private insurance, including waiving some of the program’s permissive coverage rules.
Under the approved plan, incentives will be offered to enrollees to lower their premiums. And while premiums and co-pays are relatively small, enrollees could be denied coverage or service if they fail to pay in a timely fashion, Corbett administration officials say.
But the U.S. Centers for Medicaid and Medicare Services said federal rules that apply to other private Medicaid providers will not be waived, although Pennsylvania can rely on commercial standards if they are at least as stringent as the federal rules. Private insurers already administer coverage for many of Pennsylvania’s existing Medicaid enrollees.
Corbett’s proposal covered the same population as the Medicaid expansion: working adults who make up to 133 percent of the federal poverty level, or about $15,500. Corbett administration officials say more than 600,000 more residents primarily, low-income childless, working adults â will be eligible for the coverage. About 50,000 are already enrolled in the existing Medicaid program, and administration officials say they cannot project how many ultimately will enroll.
The expansion will be paid for with 100 percent federal funds through 2016. Federal funding gradually declines beginning in 2017 to 90 percent of the cost.
Meanwhile, Corbett is facing an uphill battle to win re-election on Nov. 4 against Democratic challenger Tom Wolf, who says he would have expanded Medicaid when the money became available at the start of the year.
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