Pennsylvania Gov. Tom Wolf started working to deliver on a campaign promise soon after taking office: dismantling his GOP predecessor's alternative Medicaid expansion. Some providers and patient advocates are concerned about collateral damage as 200,000 enrollees switch plans.
Under former Gov. Tom Corbett's Healthy Pennsylvania program, the state built a second Medicaid managed-care system, separate from its HealthChoices Medicaid system that serves about 1.6 million residents. About 600,000 residents are eligible for the expanded coverage and about 200,000 have enrolled.
Wolf argues that the program's structure, devised to put a conservative spin on expanding coverage, has created confusion for recipients and led to some special populations being placed in the wrong plans. Moving these enrollees to HealthChoices, Wolf said, will "streamline the system so that people can see a doctor when they are sick and healthcare professionals have more time to concentrate on providing quality care.”
State officials have said they hope to keep all of the enrollees with the same insurance carrier and move them to that company's HealthChoices plan.
But the transition won't be simple. Healthy Pennsylvania pays providers more than HealthChoices. Not every insurance company that has a Healthy Pennsylvania plan offers a HealthChoices plan, and not all those that do offer both in the same areas of the state. This is a problem because Pennsylvania is broken up into coverage regions were only certain plans can offer Medicaid coverage.