As attorney general and now as governor, Gov. Tom Corbett has continually fought against Obamacare. That's why, when states were given the choice to expand Medicaid, an entitlement program, he said no. Expansion would have put 1 in 4 Pennsylvanians on public welfare, which is simply not sustainable for our taxpayers. Obamacare has significantly increased government bureaucracy and served only to drive up costs for families and small businesses.
There is a better way to achieve true health care reform for Pennsylvania, and Pennsylvanians deserve more than a Washington, D.C., one-size-fits-all approach. Healthy Pennsylvania is an innovative, Pennsylvania-specific plan to reform Medicaid, protect taxpayers and increase access to quality, affordable health care on the private, commercial market.
With our Medicaid costs currently accounting for 29 percent of the state's budget and crippling our ability to pay for other key services like education and public safety, we knew we needed to look at ways to reform our Medicaid program before we could consider increasing access to quality, affordable health care.
So we took a real look at Pennsylvania's Medicaid program for the first time since its inception — specifically, at how our beneficiaries are using the program today.
We knew there was a better way to tailor Medicaid benefits to the actual needs of recipients and align them more with the private market. A healthy young person does not need the same benefits as an older Pennsylvanian or someone with a chronic illness. By basing our plans on actual needs, we can make better use of taxpayers' money, while still ensuring eligible individuals get the care they need. Our plan will screen eligible individuals to determine whether they need a high-risk benefit plan or a low-risk one.
We also needed to find a way to encourage people to build a relationship with their health-care provider. We know that a strong connection to a primary care physician leads to healthier outcomes and taxpayer savings $1 spent on preventive care can save up to $6 later. So we set up a system to motivate healthy behaviors, such as an annual check-up, which is similar to what is done in the private sector.
There has traditionally been a large gap between our Medicaid-served population and those who receive private coverage, making the transition from one to the other very difficult. To ease this transition between public and private health care, we are creating a pathway to independence through this program that links participants with job training, education resources and a Healthy PA Career Coach, while encouraging healthy behaviors and personal responsibility. In this way, we can encourage employment and personal responsibility through incentives — all of which will help beneficiaries to more easily transition to employer-based health care.
The premium structure we developed is, again, in line with commercial coverage rules. As recipients earn more income (above the federal poverty level), they will have a modest premium that can be lowered through healthy behaviors, just like all state employees and many private sector workers can do today through their employer-sponsored coverage. The premium will help taxpayers afford the program and enable us to provide access to coverage for more people.
By using the private, commercial market to increase access to health care, Healthy Pennsylvania does not expand an entitlement program or put additional burdens on the state's hard-working taxpayers. It allows us to save our funding for those who will most need public assistance in the future, such as individuals with disabilities, seniors and children. And it provides greater access to health care and health care choice for consumers, with a large network of commercial insurers currently under application to serve Healthy Pennsylvania recipients.
Through Healthy Pennsylvania, we will provide quality, affordable health care in a way that won't put a strain on our ability to fund other critical public services and programs for years to come.
It's a good deal for both low-income Pennsylvanians who have been waiting for coverage and for our taxpayers who will save $4.5 billion over the next eight years.
— Beverly Mackereth is Pennsylvania's secretary of Public Welfare and a former state representative from York County.