Friday, June 19, 2015

Housekeeping note: Pennsylvania story in progress

A note re slow blogging: I've been engaged in my Pennsylvania project -- that is, exploring the implications of some odd enrollment figures in the state.. Specifically, though there's apparently over 140,000 Pennsylvania 2014 QHP enrollees who are now eligible for Medicaid, less than 40,000 2014 QHP enrollees had disenrolled as of March (or at least, to HHS's knowledge as of March). I've had the chance to interview one person newly eligible for Medicaid in 2015 who discovered that fact in February but only applied this month, in the interim paying over $300 per month for an unsubsidized private plan. The resulting story is written but not yet placed (or edited; I've got to cut it by 60%). I've learned a ton in the process.

One useful sidelight: an enrollment counselor at the Pennsylvania Health Access Network tells me that more than half of the people they enrolled in QHPs in 2014 did in fact have household incomes under 138% FPL and so are now eligible for Medicaid. While you might expect that a social service agency's client base might tilt toward lower income buyers, PHAN works all over the state, and that percentage is consistent with CMS's estimate of 141,000 households with QHP enrollees likely to be eligible for Medicaid in 2015.

One other interesting fact: in Pennsylvania, children in households with incomes under 138% FPL don't go into CHIP; they go into a separate, and I'm told inferior, children's Medicaid program. My contact told me that (at least in wealthy Bucks County, where she lives) there are no network adequacy problems in CHIP -- all doctors accept it (more specifically, if they're in a given insurer's network, they'll also be in that insurer's CHIP managed care program).  Children's Medicaid is a dramatic contrast: none of my contact's children's doctors accept it.

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