By Tara Murtha, WLP Staff
Two big problems with Pennsylvania Medicaid emerged yesterday [December 22].
The problems aren’t with Medicaid per se, but with the chaos-riddled transition from traditional Medicaid to Governor Corbett’s controversial, non-expansion alternative. To further complicate matters, Governor-Elect Tom Wolf, who promised to expand Medicaid as intended under the Affordable Care Act, takes office next month, and benefit changes are scheduled to take place January 1.
Under the Affordable Care Act, states are encouraged to expand access to Medicaid coverage, with the federal government picking up the tab through 2016 and then paying no less than 90 percent on a permanent basis.
The background: Ever since the Supreme Court decided that states can refuse to expand Medicaid, the situation here in Pennsylvania been a saga fueled by partisan politics–at the expense of the health and well-being of more than 500,000 low-income residents.
As every state bordering Pennsylvania expanded Medicaid, Pennsylvania has become “the island of the uninsured.”
In order to obtain the federal dollars without actually expanding Medicaid, the Corbett administration assembled an alternative plan called Healthy Pennsylvania, called Healthy PA for short. The plan was “met with harsh criticism by many and for good reason.”
As predicted by experts and advocates all along, the federal government rejected the majority of proposals within HealthyPA, such as tethering work requirements to health benefits. The rejection shouldn’t have been a surprise to the Corbett Administration either, since some of the proposals had already been refused in other states even before Pennsylvania submitted this proposal.
In August, after nearly a year of negotiation, the federal government approved a stripped-down version of HealthyPA. Then in November, Corbett became the first Pennsylvania governor in 60 years to lose re-election when people of the Commonwealth voted Tom Wolf into office.
Governor-Elect Tom Wolf ran on a promise to expand traditional Medicaid.
Meanwhile, 500,000 residents are still left in the gap created by Corbett’s refusal to expand last year.
Now, as Governor Corbett gets ready to leave the governor’s mansion, the whole system is a mess.
On December 19th, Pennlive.com reported that healthcare providers serving low-income mentally ill and drug-addicted Pennsylvanians state stopped receiving reimbursement for services because of a “glitch” in the transition process.
Deb Beck, president of the Drug and Alcohol Service Providers Organization of Pennsylvania, said the problem is creating a crisis for providers, particularly small nonprofits, which are being forced to decide whether to swallow the cost of care or deny treatment.
“It’s just incredible,” Beck said earlier this week. “We have families who desperately want help, kids who want help and access. This has become a nightmare.”
On December 22, Community Legal Services (CLS) announced a class-action lawsuit against the Pennsylvania Department of Human Services (formerly Department of Public Welfare).
The lawsuit, Mendez v. Mackereth, alleges that the Pennsylvania Department of Human Services (DHS, formerly the Department of Public Welfare or DPW) is assigning 1.1 million adult Medical Assistance recipients to benefits packages that do not meet their needs using secret standards and without proper notice.
Domestic violence survivors are among the groups most effected by the cuts.
The suit seeks a preliminary injunction before January 1, when benefit cuts are scheduled to begin.
“Pennsylvania is out of step with the rest of the country,” said Jane Perkins, Legal Director at NHeLP. “It is implementing strict benefits cuts using unlawful secret standards at a time when many states are expanding access to health coverage.”