Senate Committee Approves Bill Establishing Responsible Conditions on Medicaid Expansion

For Immediate Release
6/28/13

HARRISBURG – The Senate Public Health and Welfare Committee today approved legislation establishing a series of fiscally responsible conditions that would have to be met before Pennsylvania would participate in any expansion of Medicaid under the federal Affordable Care Act.

“The expected cost just to continue providing present benefits for those currently Medicaid eligible is estimated to be an additional $438 million for the coming year,” said Sen. Pat Vance, chair of the Senate Public Health and Welfare Committee. “While we welcome the opportunity to receive additional funding to provide coverage for those in need, we must ensure that we have the resources available for those already being served. While expanding healthcare coverage to as many people as possible is a worthwhile goal, we need flexibility in order to do so without breaking the bank.”

Offered as an amendment to House Bill 1075, the language adopted by the committee requires that any expansion of Medicaid in Pennsylvania must include certain options and reforms, including:

  • Continued operation of the Children’s Health Insurance Program, which was enacted in 1992 and provides health insurance to children and teens;
  • Continued emphasis on reducing waste, fraud and abuse, including the use of predictive modeling, which has been described as “a revolutionary new way to detect fraud and abuse” by Dr. Peter Budetti, the Director of Program Integrity at the Centers for Medicare & Medicaid Services;
  • Reasonable employment and job search requirements for those physically able;
  • Latitude to modify the program’s benefit design to meet changing needs and demands;
  • Improved access and continuity of care, including federal support for community-based health centers, to provide effective preventive care;
  • Continued federal support for the Commonwealth’s existing gross receipts tax on Medicaid MCOs; and
  • Affirmation that expanded coverage will not constitute an entitlement.

The amendment also includes provisions ensuring that Pennsylvania will immediately stop participating in the program if federal support falls below the established amounts of 100 percent in 2014-16, 95 percent in 2017, 94 percent in 2018, 93 percent in 2019, and 90 percent in 2020 and each year thereafter.

Finally, the amendment requires the Department of Public Welfare to submit an application to the federal government by October 1, 2013. It establishes July 1, 2014, as the target date for Pennsylvania to begin participating in the program if the conditions are met.

The bill as amended now moves to the full Senate for consideration.

Vance’s district includes all of Cumberland County and Carroll, Fairview, Franklin, Monaghan, Warrington and Washington townships and Dillsburg, Franklintown and Wellsville boroughs in York County.

CONTACT:

Tracy Polovick
(717) 787-8524