Governor Announces Medicaid Plan

Chris Lilienthal |

Governor Tom Corbett announced his “Healthy PA” plan Monday that would expand health coverage in Pennsylvania under the Affordable Care Act. His plan will depart from the federal law’s vision of Medicaid expansion by using private health insurance plans to deliver the coverage. The Governor’s plan also institutes new requirements for all Medicaid enrollees, including monthly premiums and work search requirements, that could make it more difficult for people to access health coverage. The federal government must approve the plan before it can go forward.

At the Pennsylvania Budget and Policy Center, we are still reviewing all the details of the plan, and many questions remain. You can read the Governor’s “Healthy PA” proposal here and details of his Medicaid changes here.

One point we do want to make right now. The Governor said during his press conference that Pennsylvania’s Medicaid program was costlier than other states. It is important to understand that very few healthy adults receive Medicaid coverage in Pennsylvania, with most enrollees being children, seniors, and people with disabilities. Seniors and people with disabilities requiring nursing care cost more to cover.

Distribution of Medicaid Enrollees by Enrollment Group, FY 2009

Pennsylvania also has fewer Medicaid enrollees treated in home and community based care, which is another reason costs are higher. Pennsylvania spends 22% of its long-term care budget on home and community based care, while the national average is 40%.

Overall, Pennsylvanians who are elderly or have disabilities account for 40% of the total population served by Pennsylvania’s Medicaid program but 74% of all expenditures.

Medicaid Expenditures and Enrollees by Category of Assistance, Fiscal Year 2013-14
Source: Governor’s Executive Budget, 2013-14