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September 2014 St@teside

Tracking the Spread of Medicaid Expansions


On Thursday, August 28, Pennsylvania Governor Tom Corbett (R) received federal approval to implement a Medicaid expansion. Pennsylvania is the 28th state, including the District of Columbia, to expand Medicaid under the Affordable Care Act, and the fourth to do so through an 1115 waiver process (the others include Arkansas, Michigan and Iowa). Effective January 1, 2015, “Healthy Pennsylvania” will expand Medicaid to adults earning below 133 percent of the federal poverty level by offering them the option to enroll in a Medicaid managed care plan. According to the Center for Medicare and Medicaid Services (CMS), the expansion could help nearly 500,000 Pennsylvanians get health insurance. CMS rejected Pennsylvania’s proposal to tie expanded coverage to a work requirement; however, CMS allowed the state to charge some of the highest premiums in the country, up to 2 percent of household income, beginning in 2016.


Despite intentions to pursue a full Medicaid expansion in Virginia, Governor Terry McAuliffe (D) announced a much smaller plan on Monday, September 8 to take unilateral action to provide health insurance to 25,000 residents. The plan will cover 20,000 individuals with a severe mental illness (SMI) and 5,000 children of low-income state employees. It is not clear how many of these children may already have access to health insurance. The plan is paid for in part by the federal government and in part by the state, and it involves outreach to Medicaid-eligible individuals who are not currently enrolled. A full Medicaid expansion, which would expand coverage to nearly 400,000 Virginians, was debated in a September 18 special legislative session, but the Medicaid expansion bill was struck down by the House before it could go to a formal vote.

States to watch:
Indiana has submitted an 1115 waiver that is still pending approval form CMS, and Governor Gary Herbert has been in negotiations with the Department of Health and Human Services over his alternative expansion plan for Utah.