HARRISBURG – Gov. Tom Corbett began seeking federal approval Wednesday for his plan to bring billions of federal Medicaid expansion dollars to Pennsylvania to cover a half-million working poor residents through private health plans, although advocates for the poor and uninsured called it bureaucratic and punitive.
The Corbett administration submitted the plan to the U.S. Centers for Medicare and Medicaid Services, which has given at least partial approval to proposals by other states, including Arkansas and Iowa, that sought similar modifications to the Medicaid expansion envisioned by the 2010 federal health care law.
Corbett’s public welfare secretary, Beverly Mackereth, said the administration is backing off certain elements that were criticized as barriers to coverage, although not enough to mollify every critic of a draft plan the administration issued in December.
In any case, any new coverage is expected to wait until January 2015, when Mackereth has said the administration will have the technology and staff to handle the new program.
Meanwhile, the Republican governor is running for a second four-year term this year and may have to sustain criticism until then that he did not move quickly enough to draw down the federal Medicaid expansion dollars when they became available Jan. 1.
Corbett, a critic of Medicaid who calls the five-decade-old program inefficient and bloated, refuses to expand it. Instead, he wants to use dollars set aside for expansion to instead purchase private insurance policies for about 500,000 newly eligible adults, an idea pioneered by Arkansas.
Mackereth said Wednesday the administration is still contacting insurers and trying to figure out how the program of subsidizing private coverage plans will work.
The Pennsylvania Association of Community Health Centers and the Pennsylvania Medical Society said they support the proposal.
The revised plan would relax usage limits on certain medical services it wants to require for able-bodied adults in the existing Medicaid program.
It also would ensure that rural health centers and federally qualified community health centers are automatically enrolled under the insurance plans subsidized by the Medicaid dollars.
The previous draft had forced them to negotiate with the insurers, but Mackereth said the administration is putting an emphasis on providing access to primary care.
The administration said it also is backing off demands that enrollees complete work-search requirements and pay premiums instead of co-pays in the first year as a condition of getting coverage, although advocates for the poor and uninsured warned that those elements remained troublesome.
For instance, once the work-search and premium requirements take effect, there will be “lockout” periods during which people cannot get coverage if they fail to meet the requirements.
“So you better not get sick during that time,” said Richard Weishaupt, a lawyer with Community Legal Services of Philadelphia, a public interest law center that advocates for the poor. “No state has ever gotten a waiver to do the lockouts.”