Pennsylvania Gov. Tom Corbett has not yet made a decision regarding implementation of a state health insurance exchange as required by President Obama’s health care law in the wake of the presidential election.
“We’re looking into all of the options at this point in time,” said Christine Cronkright, a spokeswoman for Corbett.
Pennsylvania lawmakers asked the federal government several questions in August about implementing two major features of the Patient Protection and Affordable Care Act. They are still waiting for answers, particularly regarding the costs for the health insurance exchange and Medicaid expansion.
Whichever route the state takes, the exchange must be operational by the start of 2014. Whether the state pursues the optional Medicaid expansion by January 2014 is also uncertain.
Exchange Information Requested
Although Pennsylvania held onto a $33 million federal grant for implementation of the exchange, the Pennsylvania Insurance Department has said it won’t decide on how to plan for the exchange until it has more information from Washington.
“Given the extent and nature of the questions that remain open, we have determined that at this time it would be imprudent for us to continue extensive planning efforts until we receive answers to these items,” wrote Insurance Department Commissioner Michael Consedine in an August letter to U.S. Health and Human Services Secretary Kathleen Sebelius.
The 26 questions his office sent to Sebelius focused on the cost, scope, and deadlines associated with the exchange, which is similar to a marketplace for individuals to purchase health insurance by comparing plans. A state could operate the exchange by itself, abdicate to the federal government, or enter into a “hybrid” partnership.
Medicaid Less Clear
It is less clear whether Corbett will choose to expand Medicaid, a decision that now rests with his administration thanks to the U.S. Supreme Court’s June ruling.
The new national eligibility limits for Medicaid will expand to 133 percent of the poverty level, or an annual income of $14,404 for a single person or $33,657 for a family of four. In Pennsylvania, the expansion would provide Medicaid coverage to 750,000 residents by 2014, according to estimates from the Department of Public Welfare provided in the wake of the court decision. The federal government would pay for 100 percent of the expansion costs until 2016, slowly decreasing its share to 90 percent by 2020 and thereafter.
In a letter to Sebelius also sent in August, Department of Public Welfare Secretary Gary Alexander asked 21 questions about funding, eligibility requirements for recipients, the type of plan expected, and extending the expansion to a later date.
“Pennsylvania’s focus remains on getting health care reform done right, not just done quickly,” Alexander wrote.
In the letter, Alexander expressed concern about the pressure the law would place on the state budget, with Medicaid spending “crowding out” other expenditures like transportation and education. Sebelius’ office has yet to respond.
Melissa Daniels ([email protected]) writes for the Pennsylvania Independent.