Affordable Care Act

Republican Governors Opt-In to Medicaid Expansion

By Sharon Ward, Third and State

There is growing bipartisan agreement that the optional expansion of Medicaid provided by the Affordable Care Act is too good an opportunity to pass up.

This month, the Governors of Arizona and North Dakota, both Republicans, announced their intention to opt-in to the Medicaid expansion, joining their counterparts in Nevada and New Mexico. To date, 14 states have decided to expand Medicaid in 2014, and another seven are leaning toward expansion. Pennsylvania remains among the 21 undecided states.

Support for Medicaid Expansion Growing

Here’s what Arizona Governor Jan Brewer had to say about Medicaid:

Mind the gap: Opting Out of Medicaid Expansion Leaves Low-income Families Behind

By Michael Wood, Third and State

Federal health care reform is moving forward thanks to the U.S. Supreme Court’s ruling last year — and it is a great deal for Pennsylvania. Unless the state decides to “opt out,” Medicaid coverage will be expanded to include many Pennsylvanians who are uninsured.

One group that will benefit immediately are parents with incomes up to 133% of the federal poverty level ($25,390 for a family of three). The benefits don’t end there: others who don’t receive health coverage through their work will be able to buy insurance on a competitive health marketplace or exchange — making coverage more affordable.

However, if Governor Corbett prevents the Medicaid expansion, it will create a coverage gap for families between 46% and 100% of poverty, as the chart below shows (click on it for a larger view).

Those families between 46% and 100% of poverty earn too much to qualify for Medicaid (for a family of three, this means earning over $8,781 but less than the federal poverty line of $19,090). These families won’t receive Medicaid coverage, and they won’t receive subsidies to buy health coverage.

We all benefit when more people have health coverage. Let’s make the right decision in Pennsylvania and expand Medicaid coverage.

Will Pennsylvania Take Full Advantage of Health Reform?

By Chris Lilienthal, Third and State

With the election decided, it is now clear that the Affordable Care Act is here to stay. That’s great news for Pennsylvanians, some of whom have already begun to benefit from the health reform law, and many others who will see more gains as major provisions take effect in 2014.

As Judy Solomon writes at the Off the Charts Blog, a key provision of the law will allow states to expand Medicaid to cover low-income adults earning up to 133% of the poverty line, with the federal government covering most of the costs:

The question now is whether some states will squander this opportunity to cover millions of uninsured Americans.

Coverage for more than 11 million poor, uninsured adults is at risk if states don’t expand Medicaid, according to the Urban Institute.

Status of Health Reform Medicaid Expansion

As you can see in the chart above, Pennsylvania is among the states that have not made a clear decision on the Medicaid expansion. 

Don't Weaken PA's Oversight of Health Insurance Rate Hikes

Many states have taken steps to ensure that there is a meaningful review of proposed health insurance rate increases for small businesses and individuals.

Pennsylvania, however, is headed in the opposite direction with legislation in the House and Senate that would keep more consumers in the dark and undermine the state’s ability to review most rate hikes.

House Bill 1983 and Senate Bill 1336 would extend rate review to insurance providers that currently escape any scrutiny, but they also reduce the Insurance Department’s authority to review and disapprove rates. The bill would give insurers license to raise individual and small business rates by 9.99% annually without any review at all. Small employers already struggling from the recession cannot afford continual rate increases and deserve to have better protection than this bill affords.

You can get more details in a memo that Pennsylvania Budget and Policy Center Director Sharon Ward wrote to editors and reporters today.

Under current state law, the Pennsylvania Insurance Department has some authority to review rate increases. It is not a perfect system, but the Department has used it effectively to perform rigorous reviews of numerous rate proposals. According to a recent Government Accounting Office study, in 2010, 37% of rate filings were reduced or withdrawn after Insurance Department review, ranking Pennsylvania 9th in the nation.

Instead of curtailing the Department’s authority, lawmakers should improve upon it with greater transparency, citizen input and meaningful review of all rate proposals.

Six Months after the End of adultBasic

A blog post by Sharon Ward, originally published at Third and State.

It has already been six months since Pennsylvania pulled the plug on the adultBasic health insurance program for 37,588 people. The Pennsylvania Budget and Policy Center recently took a look at what happened to the Pennsylvanians who lost their adultBasic coverage on the first of March. While some found health insurance elsewhere, many have simply fallen through the cracks.

In all, fewer than 40% of former adultBasic enrollees have enrolled in Medical Assistance or Special Care, a low-cost, limited benefit product offered by Pennsylvania’s Blue Cross/Blue Shield plans. These were the two options most touted as alternatives for adultBasic enrollees.

According to data provided by the Pennsylvania Departments of Public Welfare and Insurance, only 12,814 former enrollees signed on to the Blues’ Special Care — about 34% of those enrolled in adultBasic when it ended. Special Care came at a cost four times more expensive than adultBasic, and with limits on medical coverage including a four-doctor-visits-per-year cap that may have kept it out of reach for most adultBasic enrollees.

Building a Competitive Insurance Marketplace in PA

A blog post from Christopher Lilienthal, originally published on Third and State.

So have you ever used Travelocity to book a flight? Or the Consumer Reports web site to research a new car?

Then you probably know the value of comparative shopping. I, for one, never book a flight before comparing just about every option and airline. What is the cheapest day of the week to fly, which airline offers nonstop flights, how long will I be in the air?

As Antoinette Kraus of the Pennsylvania Health Access Network (PHAN) wrote in an op-ed last week:

Sites like Travelocity have made air travel, car rentals and hotel bookings more convenient, competitive and affordable.

The same can't be said for health insurance, but that's about to change. The federal Affordable Care Act calls for the creation of competitive health-insurance marketplaces by 2014 to provide individuals and small businesses with a place to buy high-quality, affordable health coverage.

Pennsylvania's Insurance Commissioner is holding hearings this month to gather public input on what the state's new health insurance marketplace should look like. Hearings were held outside Pittsburgh and Philadelphia earlier this month, with the third and final hearing happening today near Harrisburg. Sharon Ward of the Pennsylvania Budget and Policy Center will be one of the testifiers at that hearing.

Pennsylvania Lawmakers Get a Lesson on Massachusetts' Health Insurance Exchange

A blog post from Emma Lowenberg, originally published on Third and State.

Members of the Pennsylvania House Insurance Committee heard from a national expert today on Massachusetts’ experience structuring a health insurance exchange.

States have until 2014 to create state-based health insurance exchanges that meet the criteria set forth in the Affordable Care Act. If they do not create a satisfactory exchange by then, the federal government will establish one for them.

While emphasizing that there is no “one size fits all” approach for states as they structure insurance exchanges, Dr. Jon Kingsdale said Pennsylvania can learn a thing or two from the Massachusetts experience.

Syndicate content