Medicaid expansion — with conditions


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Gov. Tom Corbett was joined Sept. 16 in Harrisburg by health-care professionals and advocates as he unveiled his Healthy Pennsylvania plan to increase access to quality, affordable health-care options for all Pennsylvanians.
“My plan for a Healthy Pennsylvania works to ensure that every child has access to health-care coverage and that every Pennsylvanian has access to a family doctor or health-care provider,” Corbett said. “It’s a Pennsylvania-based plan that is based on common-sense reforms, creates real health-care choices, reduces government bureaucracy and provides a pathway to independence for all Pennsylvanians.”
The plan was endorsed by health-care leaders such as Dr. C. Richard Schott, a practicing physician from suburban Philadelphia and president of the Pennsylvania Medical Society.
“The Healthy Pennsylvania plan announced today by Gov. Corbett recognizes the need to take positive actions to improve the health of all Pennsylvanians,’’ Schott said. “The Pennsylvania Medical Society applauds the governor’s plan and looks forward to continue working with him and other stakeholders to improve the health of all Pennsylvanians.”
Additional supporters in attendance for the Healthy Pennsylvania launch included the Hospital and Healthsystem Association of Pennsylvania (HAP), Pennsylvania Association of Area Agencies on Aging, Pennsylvania Pharmacists Association, Insurance Federation of Pennsylvania Inc. and families from the Harrisburg region.
Corbett’s Healthy Pennsylvania plan focuses on improving access, ensuring quality, and providing affordability through the following initiatives:

Improving Access

* Get all kids insured in Pennsylvania: Eliminate the mandatory six-month waiting period for Pennsylvania’s Children’s Health Insurance Program (CHIP), allowing all Pennsylvania children to have continued and timely access to CHIP coverage; reauthorize the program in the legislature; and expand current enrollment and outreach efforts.
* Promote access to primary health care: Seek additional federal funding, above the $4 million provided in this year’s state budget, to build and expand community-based, primary care health clinics throughout Pennsylvania; and continue to support loan forgiveness programs to encourage primary health-care providers to practice in rural and underserved areas of the state.
* Enhance care delivery through technology: Continue to expand the use of health information technology, including using telemedicine to bring specialty care into underserved areas of the state and using electronic health records.

Ensuring Quality

* Support older Pennsylvanians and persons with disabilities: Build upon the $68 million commitment in this year’s budget to older Pennsylvanians and persons with disabilities by continuing to redesign services so that more people can have access to home and community-based care; and create a Long-Term Care Commission to recommend best practices that improve the coordination of care for all Pennsylvanians in need of long-term care services and support.
* Promote good public health: Convene a “Healthy Pennsylvania Summit” to continue discussions with Pennsylvania’s leading public health and research universities, employers, communities and physicians around promoting preventative health best practices across the commonwealth; and support and expand community-based health partnerships, with community partners such as libraries and schools.
* Ensure safe and appropriate access to prescription medication: Enhance the prescription drug monitoring program to help patients receive addiction treatment and reduce the criminal diversion of prescription drugs. Corbett also will partner with local law enforcement to support a statewide “Drug Take-Back” program that gives Pennsylvanians a safe and secure way to dispose of unused prescription medications.

Providing Affordability

* Continue reforms of Pennsylvania’s medical liability system: Adopt the “Apology Rule” for health-care providers to allow them to express empathy for unforeseen outcomes without fear that their statements will be seen as an admission of error.
* Reform Pennsylvania’s Medicaid program: Secure agreement from the U.S. Department of Health and Human Services to allow the state to apply common-sense Medicaid reforms including:
* Aligning Medicaid benefits with private, commercial insurance and the federal standards for essential health benefits, mental health parity and preventive care (benefit package for children will not change and community supports for older Pennsylvanians and persons with disabilities will remain the same);
*  Implementing a revised cost-sharing model for current adult Medicaid recipients that rewards use of preventive care to reduce emergency room use — this will be accomplished through instituting a reasonable monthly premium on a sliding scale from $0 to $25 and removing confusing co-payments; and
*  Requiring work search for all unemployed working-age Medicaid beneficiaries, with limited exceptions, connecting them to jobs and job training as needed through Pennsylvania’s JobGateway.
If the federal government grants Pennsylvania the ability to implement these reforms and achieve significant cost savings, Pennsylvania will work with the federal government to use federal funds and give approximately 520,000 additional low-income Pennsylvanians the ability to enroll in private health insurance plans through the federal health insurance exchange.
“Healthy Pennsylvania provides a path to wellness and care for all Pennsylvanians,” Corbett said. “The plan ensures quality, access and affordability in a fiscally responsible framework. We are re-directing funding to better serve those who most need our support.’’
“This is a Pennsylvania solution that reforms a broken and financially unsustainable program. Healthy Pennsylvania is grounded in independence for all Pennsylvanians, reducing government bureaucracy by using the private health-care market, and creating health-care choices for consumers. I will not accept Washington’s ‘one-size-fits-all’ approach for Pennsylvania, and I will not expand an entitlement program.”
Medicaid costs currently account for 27 percent of the entire general fund budget, with one in six Pennsylvanians on the program.
Allowing access to private coverage, versus an expansion of Medicaid, would be more quickly implemented, require less bureaucracy, offer more provider options, and protect state programs by not putting Pennsylvania at risk if the federal government does not live up to the promise of funding.
While speaking to Corbett at the launch, HAP’s president and chief executive officer, Andy Carter thanked the governor for his decision to move forward on the health-care initiative and said, “We applaud your decision to embrace what hospitals consider the cornerstone of a high performing health system — effective insurance coverage for all Pennsylvanians.”
Corbett outlined the Healthy Pennsylvania plan after a tour of the emergency room and Riverview Primary Care at PinnacleHealth’s Harrisburg Hospital. During the tour, he learned about the hospital’s system to identify and triage patients based on their needs, which helps the organization reduce costs within the emergency room and promote primary care.
“We are pleased with the governor’s support of increasing access to integrated, quality care while controlling costs,” shared Michael A. Young, president and CEO for PinnacleHealth. “Innovations such as Riverview Primary Care improve the health of Pennsylvanians and reduce costs by providing the right care, from the right provider, at the right time and in the right place.”
For more information, visit www.pa.gov.

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