Friday, October 17, 2014

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Healthy Pennsylvania Subsidizes Health Insurance 
for Low-Income Families and Individuals

The federal Centers for Medicare and Medicaid Services (CMS) announced their approval of an amended version of Pennsylvania Governor Tom Corbett's Healthy Pennsylvaniaproposal in late August 2014.
Beginning January 1, 2015, individuals and families with incomes below 138% of the federal poverty level (see chart below) will be eligible to enroll in health insurance offered by private Medicaid Managed Care companies in a new system run by the Commonwealth. Healthy Pennsylvania will cover individuals who did not qualify for insurance subsidies for the Affordable Care Act because Pennsylvania did not participate in Medicaid Expansion.

When Does Coverage Begin?
Enrollment begins December 1, 2014, and coverage will become effective January1, 2015. Like traditional Medicaid, coverage can be retroactive to help with medical bills.
How Much Will Healthy Pennsylvania Cost?
It will cost nothing in 2015. No newly eligible enrollee will have to pay premiums in 2015. In 2016, premiums can be imposed on people with incomes above 100% of the federal poverty level and cannot exceed 2% of an enrollee's monthly household income.

Who Qualifies for Coverage Under Healthy Pennsylvania?
Pennsylvanians earning below 138% of the federal poverty level will be eligible. That includes: 

How Does Healthy Pennsylvania Change Coverage for Current Medicaid Enrollees?
Individuals currently covered by Medical Assistance for Workers for Disabilities (MAWD), SelectPlan for Women, General Assistance-related MA, or Medically-Needy Only MA would move into new Healthy PA coverage and receive the benefits of new enrollees. Pennsylvania's Department of Public Welfare is seeking to move the 1.1 million adults currently enrolled in Medicaid to either a "High Risk" or "Low Risk" plan. 

Details Still Need to be Clarified
The state still needs to unveil the health screening questionnaire to move Medicaid enrollees into "High Risk" and "Low Risk" plans. Enrollment issues and contact information still need to be developed. There is an issue brief and information on Healthy Pennsylvania coverage and changes in Medicaid coverage on our Recovery Community Organization Healthcare Reform website here and go to the Healthy Pennsylvaniasection.

Open enrollment for the Affordable Care Marketplace begins on November 15, 2014. There is information on our website and in all of our centers. Check for the most recent updates on Healthy Pennsylvania and Open Enrollment on our healthcare website here.

From the PRO-ACT Public Policy Committee

This is a consortium of Recovery Community Organizations in Pennsylvania focused on recovery from drug and alcohol addiction. This website and consortium was funded by SAMHSA (The Substance Abuse Mental and Health Services Administration) BRSS TACS Grants for peer-run recovery community organizations to build a statewide network for State Peer Health Reform Education.

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