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Gov. Tom Corbett Demands Alterations to Pennsylvania’s State Plan Under Medicaid as a Condition of Expanding Coverage

November 14, 2013

On Sept. 16, 2013, Pennsylvania Governor Tom Corbett announced his intention to extend Medicaid coverage to all Pennsylvanians with incomes below 133 percent of the FPL, contingent on the Federal Centers for Medicare and Medicaid Services’ (CMS) approval of numerous alterations to Pennsylvania’s State Plan governing its Medicaid program. Gov. Corbett’s proposal, “Healthy Pennsylvania: Reforming Medicaid,” would require working-age, unemployed Medicaid beneficiaries to register with the state’s JobGateway program and engage in job search as a condition of receiving benefits, with “limited exceptions.” It remains unclear whether this requirement would apply to individuals with disabilities. In addition, under Corbett’s proposal, the expansion population would receive health care through the statewide health insurance exchanges and would not receive full Medicaid benefits. However, as required by the ACA, members of the expansion population who are classified as “medically frail,” including individuals with significant mental or physical disabilities, would remain eligible for full Medicaid benefits, including Medicaid-provided LTSS. Individuals who are eligible for Medicaid through other eligibility criteria, including children in low-income families and people who receive SSI, would also continue to receive full Medicaid benefits.

Full text of the proposal is available at http://www.dpw.state.pa.us/healthypa/index.htm