Wolf administration wraps up overhaul of Medicaid benefits

By Marc Levy, Associated Press | Posted - Sep. 1, 2015 at 5:11 p.m.

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HARRISBURG, Pa. (AP) — The Wolf administration said Tuesday that it had completed the transfer of more than 1 million adult Medicaid enrollees into a single, new benefits package it had created as the program expands to record numbers under the 2010 federal health care law.

The process that the Human Services Department finished included the dismantling of changes that Gov. Tom Wolf's predecessor had sought to make to Medicaid coverage as part of Pennsylvania's embrace of the Medicaid expansion.

As of June 30, there were almost 2.6 million children and adults enrolled in Medicaid in Pennsylvania. Enrollees now include more than 400,000 who joined under the broader income eligibility guidelines that took effect Jan. 1 under the federal law, according to the department.

Human Services Secretary Ted Dallas said the agency is working to advertise the broader eligibility guidelines to people who are eligible, but have not yet enrolled. The department is on course to reach its projection of 605,000 enrollees under the expanded eligibility guidelines, perhaps next year, Dallas said.

Dallas did not find that the state's ranks of physicians or hospitals have been overwhelmed by the influx of newly insured people seeking care, he said.

The new benefits package is similar to the one enrollees had last year.

Former Gov. Tom Corbett had tried to create three different benefits programs starting Jan. 1, in conjunction with his administration's expansion of Medicaid, with conditions granted by the federal government.

However, the federal government did not approve all of the benefits changes Corbett's administration had sought before Wolf took office and put a stop to them.

Advocates for the poor had complained that Corbett's plan was administratively burdensome, confusing to enrollees and unnecessarily stingy with benefits.

Meanwhile, some enrollees had struggled to get coverage for dialysis, mental health counseling or addiction treatment, they said. The benefits program designed by the Wolf administration includes coverage for dialysis and wider behavioral health networks, they said.

The state has thus far saved money in the deal, since more than $600 million in costs to cover certain Medicaid enrollees has shifted from the state to the federal government, Dallas said.

The federal government is footing 100 percent of the cost of new enrollees through 2016. After that, its share of the bill shrinks to 90 percent over several years and the state picks up the rest.

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Marc Levy


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