Under the Affordable Care Act, states have to option to decide if they want to expand Medicaid. According to Medicaid.gov, this expansion will extend Medicaid to individuals less than 65 years of age whose income does not exceed 133 percent of the federal poverty level (approximately $15,860 for an individual, according to the New York Times).
To help encourage states to expand Medicaid, the federal government has agreed to finance 100 percent of the newly eligible individuals for three years. Starting in 2017, the government will begin phasing down to 90 percent coverage by 2020, with the states covering the difference.
So far, 25 states plus the District of Columbia have voted to expand Medicaid coverage. There is no official deadline to decide on expansion, so there’s a chance that more states will eventually opt in.
PENNSYLVANIA MEDICAID EXPANSION
Pennsylvania has not yet decided if it will pass Medicaid expansion. Governor Tom Corbett is in negotiations with Health and Human Services about his Healthy Pennsylvania plan, an adaptation of Medicaid expansion. Instead of using the estimated $4 billion of Medicaid funding to broaden the eligibility requirements of Medicaid, the money would be used to help purchase insurance plans for 305,000 citizens who are currently ineligible for Medicaid but do not qualify for government subsidies in the health insurance marketplace. He is asking for the federal government’s approval on three stipulations, which have been points of contention between state legislators:
- PRIVATE INSURANCE OPTION: If approved, new benefit packages would be offered to Medicaid recipients in addition to Medicaid packages. These packages would mirror privatized insurance plans, like those offered through most employers. Any saved money would be reinvested in these privatized insurance systems.
- COST SHARING: Instead of expanding Medicaid regulations, money from the expansion would be used to help cover costs. So qualifying recipients would pay a monthly fee for their insurance plan, while the remainder would be covered by money from the federal government.
- JOB TRAINING AND WORK SEARCH: Unemployed Medicaid recipients would be required to seek job and/or work training opportunities to receive aid. Proof of active searches would lower insurance premiums, if the measure is approved by the federal government. There has been some controversy over this portion of the governor’s plan, because Pennsylvania would be the only state to have such a stipulation. Disability rights groups are also concerned because, while the work search requirement would be waived for individuals with disabilities who are unable to work, there have, as of yet, been so specifications on how ability to work would be determined.
In September, the federal government approved Arkansas' modified Medicaid expansion. Arkansas' plan is similar to the private insurance option, without the two other stipulations. So while different from Corbett's Healthy Pennsylvania plan, it does show that the federal government is willing to consider adaptations to Medicaid expansion. However, the approval process for an alternative Medicaid expansion would take a long time. The federal government must assess and approve the plan. The state will also open up a public discussion period so that Pennsylvanians can weigh in on this option. Public discussions should begin in December 2014, and the soonest that a plan to expand coverage could be implemented in Pennsylvania would be January 2015.
MEDICAID EXPANSION AND EMPLOYMENT
If the Healthy Pennsylvania plan or some other form of Medicaid expansion passes, hundreds of thousands more individuals will gain access to health care services. This is not only a benefit to the individuals' health but to the economy as a whole.
With more residents eligible for health care, it is likely that more health care providers will be needed. And not only will job growth be seen in the medical field, but there will be an indirect effect throughout the entire job market.
According to the U.S. Department of Health and Human Services, Pennsylvania has already received millions of dollars in grants for research, development, information technology and implementation of the health insurance marketplace. Over $4 million dollars were granted to health centers across the state, which helped create 76 new jobs. With the implementation of the marketplace, more employees were needed to help Pennsylvanians enroll.
An additional $76 million has been granted to health centers to support ongoing operations and expansions. Should a center decide to expand or build a new site, contractors will be needed and equipment purchased. So government-funded expansion could also help put money back in the economy and create job growth in different fields.
Time will tell if Medicaid expansion has a positive impact on economic growth, or if Governor Corbett will reach an agreement with the federal government on his Healthy Pennsylvania plan. Until then the clock will continue to count down to January 1 and the beginning of new insurance plans across the country.
Find out more information on how to enroll here.
If you live in the Pittsburgh, Penn., area and you'd like to get more information in person, the nonprofit organizations New Voices Pittsburgh and Pennsylvania Health Access Network (PHAN) are hosting a community forum on the ACA on Thursday, November 21, 2013, at the YWCA Homewood-Brushton location, starting at 6:30 pm. Click here to learn more about this event.