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The Impact of Expanded Medicaid on Pennsylvania Women

May 15, 2015

Understanding our Progress during National Women’s Health Week 

By Emily A. Eckert, Community Health Organizer

Happy National Women’s Health Week! Did you take the time to schedule a well woman visit this week? If you have yet to do so, be sure to call your primary care doctor so you can be seen for your annual visit! As National Women’s Health Week comes to a close, the Pennsylvania Health Access Network is wrapping up our three-part educational blog series with a piece on expanded Medicaid and the benefits that the new HealthChoices is extending to hundreds of thousands of women. 

When President Obama designed the Affordable Care Act (ACA), his intention was to expand health care access to more Americans than ever before. This goal was to be accomplished by creating a health insurance marketplace for higher-income earners and qualified immigrants to purchase private insurance with financial assistance, and also by enabling states to expand their existing Medicaid programs with federal funds. 

The expansion of individual state Medicaid programs was a crucial component of the ACA— intending to close the coverage gap that had existed for so long. Prior to the ACA, Pennsylvania law excluded non-disabled and non-pregnant adults from obtaining Medicaid coverage. The ACA was designed to expand health benefits to these individuals by expanding the eligibility requirements for the program.  

In June of 2012, however, the Supreme Court of the United States ruled that penalizing states for not accepting federal Medicaid dollars to expand their programs was unconstitutional, thus making the Medicaid expansion waiver optional for individual states, not required. Prior to the Court’s decision, the Congressional Budget Office (CBO) estimated that the ACA’s Medicaid expansion would cover 17 million uninsured low-income Americans by 2022. This projected figure drastically reduced with the Court’s ruling. 

With the offer of federal funding on the table, Pennsylvania had an unprecedented opportunity to expand access to care to upwards of 600,000 residents. Under the leadership of Republican Governor Tom Corbett, however, Pennsylvania rejected the funds and refused to expand the existing Medicaid program. This decision left hundreds of thousands of Pennsylvanians in a coverage gap without access to affordable, quality health care. After extreme pressure from advocates and a bi-partisan vote in the Senate, Governor Corbett decided he would create his own version of Medicaid Expansion called Healthy PA

Healthy PA was a program full of bureaucratic red tape and drastic benefit cuts for existing Medicaid beneficiaries. Although this program promised to extend coverage to over half-a-million Pennsylvania residents, Medicaid advocates still had many concerns regarding affordability and efficiency. The Pennsylvania Health Access Network continued to advocate that traditional Medicaid expansion, with no cuts to existing benefits, was the best path for Pennsylvania.

With a new administration came a new decision on health reform in Pennsylvania, as newly-elected Governor Tom Wolf formally announced his plan to end the controversial Healthy PA expansion and expand traditional Medicaid in Pennsylvania on February 9, 2015. By expanding Medicaid eligibility to individuals earning up to 138% of the federal poverty level, Governor Wolf cleared the pathway to affordable coverage for many Pennsylvania women. This decision is paramount to keeping Pennsylvania families healthy for generations to come. 

The Medicaid program provides exceptional benefits to lower income women, including family planning services, comprehensive maternity care, treatment for chronic conditions, treatment for breast and cervical cancer, and long-term care services and supports. 

The Pennsylvania Health Access Network was among the leading advocacy organizations fighting to expand the Pennsylvania Medicaid program since the passage of the ACA. We applaud the Wolf administration for its willingness to expand essential health benefits to over half-a-million Pennsylvanians, and we look forward to continuing to connect PA residents to care. 

If you or someone you know are currently uninsured, please call our helpline at (877) 570-3642. Our certified navigators will be happy to assist you.