Pennsylvania Gov.-elect Tom Wolf will face federal, state and contractual hurdles should he try to replace his Republican predecessor's alternative Medicaid expansion initiative with the straight expansion plan he favors.
The Democrat also will confront a challenge in trying to stop the state from restricting benefits for those in the standard Medicaid program, another Republican initiative.
Open enrollment began last Monday for Healthy Pennsylvania, outgoing Gov. Tom Corbett's alternative expansion model for which as many as 600,000 people may be eligible. As part of the initiative, the state built a second Medicaid managed-care system, separate from the existing Medicaid system that serves about 1.6 million residents.
Undoing Corbett's alternative expansion will require CMS approval, said Kati Gillis, a spokeswoman for the state's Department of Public Welfare. Also, the state has binding contracts with eight health plans to offer coverage under Healthy Pennsylvania, and it's unclear if those can be broken without financial penalties, she said.
The state's General Assembly has a Republican majority in both its chambers, meaning any move by Wolf to push his own Medicaid expansion will run into opposition.
“It is important to note that although Gov. Corbett was defeated, the Republicans increased their control of the chambers in both the state House and Senate. The Legislature is likely to resist some of Gov. Wolf's changes, making it difficult to predict at this point how this will all pan out,” Izanne Leonard-Haak, a managing principal in Health Management Associates' Harrisburg, Pa., office, said in a November analysis on Healthy Pennsylvania.
Wolf had asked Corbett to stop implementing Healthy Pennsylvania because he planned to institute a simple expansion of the state's existing Medicaid program. The Corbett administration declined the request.