“Healthy PA:” What’s It All Mean?

Last Friday, Gov. Corbett released full details of his Healthy PA initiative, which seeks to expand government-funded health insurance under Obamacare (using Medicaid expansion funds to pay private insurance premiums for those newly eligible) and seeks federal waivers to reform the existing Medicaid program.

What does this mean? Is Pennsylvania expanding Medicaid? Short answer: It’s complicated. The Healthy PA proposal seeks a waiver from the U.S. Department of Health and Human Services (HHS) to use Medicaid expansion money from the Affordable Care Act.

That money would be used by low-income individuals who don’t currently qualify for Medicaid to purchase private insurance on the federal exchange. The plan requires participants to pay a portion of their premium, up to $35 per month. However, participants can reduce their premiums if they perform “healthy” tasks like getting an annual checkup.

What happens next? Hearings will be held around the state, along with two webinars, which are all scheduled from Dec. 19 to Jan. 9. The public comment period wraps up at the end of January, and then the waiver proposal goes to Washington. With another public comment period, it will take at least 60 days for the federal government to deliberate.

Will the Obama Administration approve it? That’s the multi-billion dollar question. This week, HHS approved a similar waiver from Iowa, but with a few limitations. Iowa proposed premium sharing for households earning more than 50 percent of the federal poverty level (FPL), but the federal government ruled Iowa can’t charge premiums to anyone below 100 percent of the FPL.

That’s a good indication that Pennsylvania will not obtain all the flexibility it is seeking—even though that flexibility is extremely limited.

It could be months, even years, before we know whether Pennsylvania will move forward with this major provision of Obamacare.