DPW secretary confident feds will approve Healthy PA Medicaid reform


By Andrew Staub | PA Independent

The secretary of the Pennsylvania Department of Public Welfare is confident the federal government will grant the state a waiver for Healthy PA Medicaid reform.

For the sake of Pennsylvania taxpayers, Beverly Mackereth better be right. Republican Gov. Tom Corbett is counting on $125 million in savings, which are connected to the waiver, to balance next year’s budget.

The state submitted the waiver last week, and it quickly drew questions during a state Senate appropriations hearing Monday. State Sen. Pat Vance, chairwoman of the Public Health and Welfare Committee, asked what would happen if the federal government rejects Healthy PA.

“We don’t believe that’s going to happen, senator, because they too agree that we need to reform our current system of Medicaid,” Mackereth responded.

BANKING ON IT: Pennsylvania Gov. Tom Corbett wants to save $125 million through Medicaid reform.

The waiver potentially takes on even greater importance after last week’s budget hearings revealed just six entities applied for licenses to conduct small games of chance.

Corbett’s budget proposal banks on more than $100 million in tax revenue from expanded gaming. The dearth of applicants suggests the state won’t make that benchmark.

The reliance on iffy revenue streams and savings has led critics of the governor to say his feel-good budget proposal is unsustainable. The left-leaning Pennsylvania Budget and Policy Center has already questioned whether the federal government will approve changes to Medicaid.

Lawmakers from both sides have pointed out that simply expanding Medicaid under the Affordable Care Act would have brought extra federal money.

Others, such as state Sen. John Blake, have reminded the administration that waiting for approval for Healthy PA — which would offer a private coverage option for uninsured Pennsylvanians — would leave a half -million people waiting until next year for coverage.

“I’m not persuaded that Healthy PA is the best policy for Pennsylvania,” said Blake, D-Lackawanna.

But with Medicaid expenses constituting about 30 percent of Pennsylvania’s general fund budget and the state and federal governments pouring $24 billion into Medicaid, Mackereth said something has to change.

Mackereth said the federal Department of Health and Human Services has agreed.

“No matter what we say, the facts show Medicaid is not financially sustainable,” she said.

While Mackereth is hoping for a quick decision, the Centers for Medicare and Medicaid Services — an agency within HHS — on Monday offered no indication as to how it’s leaning.

“We have received Pennsylvania’s waiver request and look forward to working with the state as we review their proposal,” spokeswoman Emma Sandoe said.

So far, the federal government has approved Medicaid coverage expansion waiver requests in Arkansas, Iowa and Michigan. Twenty-three other states have simply expanded Medicaid.

That’s not Corbett’s preferred route. That means Healthy PA — and parts of Pennsylvania’s next budget — will be in limbo as the federal government reviews the waiver proposal before starting the clock on a 30-day public comment period.

Negotiations are probably forthcoming before Healthy PA gets a green light, Mackereth said.

“We’re going to give a little,” she said, “and I hope they give a little too to get there.”

Andrew Staub is a reporter for PA Independent and can be reached at Andrew@PAIndependent.com. Follow @PAIndependent on Twitter for more.

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