After seven public hearings and more than 1,000 comments on his "Healthy PA" plan, Pennsylvania Governor Tom Corbett's administration has submitted to the federal government his revised alternative to expanding Medicaid.

 

The plan would cover an estimated 500,000 people who earn too much to qualify for regular Medicaid, but can't afford private insurance on their own.

Since the last version in December, the plan's benefits for preventive care, mental health, and substance abuse have all increased. Many other facets of Healthy PA, such as eliminating co-pays in favor of premiums, have been delayed for a year or have been redefined to affect only those making more than 100 percent of the federal poverty level.

Federal officials must approve the plan before Corbett can use funds earmarked for Medicaid expansion to bankroll Healthy PA.

One unprecedented requirement, which has garnered extensive criticism, is Healthy PA enrollees show proof of their employment or that they are searching for a job.

That requirement, which also would be delayed for a year under the revised plan, could prove to be a stumbling block during the federal review, said Department of Public Welfare Secretary Beverly Mackereth.

But the Corbett administration is convinced it is critical for weaning people off public assistance, she said.

"We believe that encouraging employment ties in very strongly to good health outcomes," Mackereth said Wednesday. "And for us, when we truly believe that that's the right thing, we're going to ask the federal government, 'Is there a way that we can make this work? Is there a way that we can incentivize people to look for employment?'"

While the new Healthy PA plan shows some small improvements, that work requirement is untenable, said Joan Alker, executive director of the Center for Children and Families and a researcher with the Georgetown Health Policy Institute.

"The governor's proposal adds an enormous amount of red tape and bureaucracy to your Medicaid program," she said. "There is an incredible amount of complexity here, and we know that red tape prevents people from getting coverage."

Nevertheless, the revisions have been endorsed by the Hospital and Health System of Pennsylvania. Andy Carter, the president and CEO, said getting insurance coverage for an additional half-million Pennsylvanians is important for better health outcomes -– as well as reducing the approximately $1 billion in charity care that hospitals across the state assume.

"We do respect the fact that there are many ways to get to coverage for all Pennsylvanians," Carter said. "And the governor and his team have proven to be very engaged in a conversation over many months to put together a plan that meets our concerns for good coverage, good access to care."

Federal officials have 15 days to review Corbett's plan, and there will be a monthlong public comment period. If it passes, Healthy PA is slated to start in January.

Neighboring Delaware and New Jersey have already expanded Medicaid.

Over the years they will draw down billions of federal dollars.

Corbett's plan seeks to use those funds to subsidize coverage through the private insurance market.