Health insurance coming for 600k, but without one program

Written by Ben Allen, General Assignment Reporter | Sep 29, 2014 6:00 AM

(Harrisburg) -- The Healthy Pennsylvania system will offer heavily subsidized health insurance for more than 600,000 commonwealth residents, but Medicaid benefits will change.

Through a state program, low-income residents can get a ride to doctor's visits, counseling sessions, or any other type of health-related appointments.

Reimbursements are also available for those who take a car or public transportation.

But starting January 1, the Medical Assistance Transportation program will only serve those who are in the existing Medicaid program, since the state Department of Public Welfare received a one-year waiver for new enrollees.

DPW Secretary Bev Mackereth says it isn't ready to take on more people.

'We need a total re-look at that system before we add another 600,000 lives.'

Mackereth says some of the program rules are outdated.

She insists the state will watch how the change affects health care next year, but couldn't identify a specific provision that would offer transportation assistance for those who have no other options.

'Individuals will have to be proactive if they are not getting what they need. Because otherwise we won't know. But we will know if they're telling somebody because we'll get the calls, we will look at every single one, to determine what's happening,' says Mackereth.

However, as many as 79,000 people who are in the existing Medicaid program called 'General Assistance' will also lose transportation benefits, because they will be forced to get coverage through the new private coverage option under the Healthy Pennsylvania plan. Those who are considered 'medically frail' (pregnant, blind, disabled, terminally ill, etc.) will continue to have access to transportation to and from doctors appointments.

The Department of Public Welfare says its determined that more than half of those likely to enroll in the new private coverage option have a job, and thus would be more likely to have access to transportation already.

The changes don't affect emergency transportation.

The federal government granted a similar waiver to Iowa for 2014.

On Friday, September 19th, WITF incorrectly reported the Medical Assistance Transportation program would end January first. This story has been edited to correct and clarify the changes to the initiative. It is not ending for all on Medicaid; in essence, its ending for those who are in 'General Assistance' and not medically frail. It also will not be provided to new enrollees through the state's health insurance expansion.