Pennsylvania and the Obama administration have reached a deal to expand Medicaid under Obamacare, the administration announced Thursday.
The state, under Gov. Tom Corbett (R), and the Centers for Medicare and Medicaid Services have been negotiating for much of the last year to expand coverage to 500,000 low-income Pennsylvanians. Under the waiver approved by CMS on Thursday, coverage will start in January 2015.
Both sides appear to have given something up in the agreement, which makes Pennsylvania the 27th state, plus Washington, D.C., to expand Medicaid.
Corbett had initially sought a requirement that enrollees be looking for a job or getting job training. There is no such requirement in the approved waiver, CMS said, though the state is planning to create a program to connect enrollees with job training and placement resources. Their participation has no bearing on their coverage, the agency said.
However, the administration did agree to allow Pennsylvania to charge premiums for some enrollees starting in 2016. People making between 100 and 133 percent of the federal poverty level can be charged premiums of up to 2 percent of their household income, the agency said. If recipients fail to pay, they can lose their coverage after a grace period.
Michigan was also allowed to require premiums for the same population. Iowa also received the authority to charge premiums under its “private option” model.
The coverage expansion will take place through Medicaid managed care, as Pennsylvania’s existing program does, which uses private health plans to administer the program. That is the same model used by Michigan; it is distinct from the so-called private option in Arkansas and Iowa, which uses Medicaid dollars to pay for private coverage on Obamacare’s insurance exchanges.
“Like we are doing in Pennsylvania, HHS and CMS are committed to supporting state flexibility and working with states on innovative solutions that work within the confines of the law to expand Medicaid to low-income individuals,” CMS administrator Marilyn Tavenner said in a statement.
Several other Republican-led states, like Indiana, are also in negotiations with CMS over Medicaid expansion.