By Melissa Daniels | PA Independent
HARRISBURG — A national health policy expert said Pennsylvania isn’t alone in holding back its decisions on the Patient Protection and Affordable Care Act.
Katharine Witgert, program manager for the research group National Academy for State Health Policy, spoke in Harrisburg at the annual presentation of the state legislature’s Independent Fiscal Office.
So far, 12 states have agreed to expand their Medicaid programs to its new eligibility standards come 2014. Some will go forward even earlier, Witgert said.
On the other end of the spectrum, seven states have said they won’t expand programs to include those who are newly eligible.
“Most of the states are still trying to decide what to do,” she said.
One of the biggest considerations states have is the cost – and that cost is tied to how many people enroll and their needs are from the Medicaid program, Witgert said.
“Who are these people? How sick or health are these people? What types of Medicaid services are they likely to use? And that will really depend on the demographics of your state,” Witgert said.
A study from the Kaiser Family Foundation says the expansion would cost Pennsylvania $1.1 billion from 2014 through 2019 if 482,400 residents enroll. If the state gains 682,900 new enrollees, the cost is around $2 billion in the same time frame.
Pennsylvania also hasn’t said if it will run a mandated health insurance purchasing exchange by itself or in partnership with the federal government. But it does have a federal grant for start-up implementation.
Nationally, fifteen states are going with a state-based exchange. Another 15 will use the federal government’s yet-to-seen system. Four will have a partnership. The rest are still announcing their plans, Wetgert said, with upcoming deadlines forcing the topic.
Witgert said state have to consider how to cover costs of the exchange after federal funds run out.
“Every state will have to figure out where that revenue is going to come from,” she said. “So far, what we’re hearing is most states will ask the insurance carriers who are selling in the exchange to pay for a fee that will cover the operating expenses.”