Healthy Pennsylvania logo

The logo for Healthy PA, Gov. Tom Corbett's plan to expand health coverage for needy Pennsylvanians.

Pennsylvania Gov. Tom Wolf, long a critic of his predecessor’s version of Medicaid expansion under the Affordable Care Act, on Monday took the first step toward replacing it.

That step was directing the state Department of Human Services to withdraw a pending piece of the Healthy PA program from further federal consideration.

Healthy PA has three benefit plans: One for healthy people, one for sick people and one for the newly eligible who have incomes up to 138 percent of the federal poverty level. Wolf proposes to replace them with a single Medicaid plan that the DHS is working with the federal government to develop.

Wolf’s plan won’t increase or decrease the number of people covered, but will likely mean an increase in covered benefits for some of them.

“Today is the first step toward simplifying a complicated process and ensuring hundreds of thousands of Pennsylvanians have greater access to the health insurance they need,” Wolf said in a news release.

Former Gov. Tom Corbett billed Healthy PA, which took effect Jan. 1, as a reform and simplification of the state's 14 existing Medicaid plans.

Wolf disagreed, with his release citing "people not receiving important treatment, confusion among recipients, and special populations being placed into the wrong plans" as examples of "complications under Healthy PA."

"Our approach will alleviate confusion, remove unnecessary red tape, and streamline the system so that people can see a doctor when they are sick and health care professionals have more time to concentrate on providing quality care," Wolf said.

The release said no coverage will be immediately impacted, and that the state "will continue to provide individuals with appropriate health care coverage" while the transition is in progress.

Ted Dallas, acting secretary of the Pa. Department of Human Services, said the department is already making changes to eligibility systems that will take effect "this spring," enabling the department to transition people from two of the Healthy PA plans to the new Medicaid one.

The third Healthy PA plan, known as the Private Coverage Option, or PCO, is for those newly eligible under the expanded income limits. The release said the transition from that plan “will occur over a longer period of time to ensure that individuals are clearly informed of these changes and they do not experience any gap in coverage."

The announcement drew quick kudos from groups including Pennsylvania Health Access Network, Pennsylvania Partnerships for Children, Get Covered America and U.S. Senator Bob Casey. 

Julie Kissinger, a spokeswoman for The Hospital & Healthsystem Association of Pennsylvania, said in an email that the association is pleased by several aspects of the plan, including that coverage will continue without interruption. However, she wrote, HAP and its members look forward to hearing details on issues including payments and contracts.

Former Gov. Tom Corbett billed Healthy PA, which took effect Jan. 1, as a reform and simplification of the state's 14 existing Medicaid plans.

Wolf disagreed, with his release citing "people not receiving important treatment, confusion among recipients, and special populations being placed into the wrong plans" as examples of "complications under Healthy PA."

"Our approach will alleviate confusion, remove unnecessary red tape, and streamline the system so that people can see a doctor when they are sick and health care professionals have more time to concentrate on providing quality care,” Wolf said.

The release said no coverage will be immediately impacted.

Ted Dallas, acting secretary of the Pa. Department of Human Services, said the department is already making changes to eligibility systems that will take effect “this spring,” enabling the department to transition people from two of the Healthy PA plans to the new Medicaid one.

The release said the transition from the third plan — the Private Coverage Option, for the newly eligible — “will occur over a longer period of time to ensure that individuals are clearly informed of these changes and they do not experience any gap in coverage.”

Wolf will need to obtain federal approval for his plan before it can be implemented,

The release did not include details of the plan, which will need to be approved by the federal government before it goes into effect. Approval from Pennsylvania’s Republican-controlled legislature is not required, but without it Wolf could have difficulty implementing the plan.

In 2013, Pa. House Republicans stripped a Medicaid expansion provision from legislation that had garnered a 40-10 vote in the Senate.

Heather Stauffer covers the health care industry. She can be reached at hstauffer@lnpnews.com or 717-481-6022.