Pennsylvania Misses Out on Performance Bonus by Failing to Simplify Enrollment – Say Ahhh! A Children’s Health Policy Blog

Thumbnail image for Thumbnail image for Thumbnail image for Thumbnail image for ann bacharach.jpgBy Ann Bacharach, Pennsylvania Health Law Project

Congratulations to the 23 states who received bonus
payments of more than $296.5 million for successfully increasing their Medicaid
enrollment and implementing five of eight simplification strategies.  I’m jealous. 

While Pennsylvania has increased its Medicaid enrollment
between 2008-09 and 2010-11 by more than 10%, it has left an estimated $300
million on the table by failing to implement three more simplification
strategies.  PA has two: 1) no
face-to-face interview requirement for children, and 2) no assets test for
children.  If it wished,
Pennsylvania could easily qualify for the bonus payments. Pennsylvania could:
  • Implement Express Lane eligibility using the subsidized
    child care system or the free and reduced price school meals program;
  • Implement presumptive eligibility at the eight
    children’s hospitals or related institutions in the commonwealth;
  • Make changes to its Medicaid renewal practices and meet
    the test for a single application process;
  • Implement administrative renewal using the eleven electronic
    databases it has at its disposal;
  • Align Medicaid with CHIP and provide 12-month
    continuous eligibility.

Instead of drawing down millions of dollars that could be
used to improve efficiency and program integrity, reduce the paperwork burden
on families and prepare for the implementation of the Affordable Care Act by
simplifying existing systems, processes and procedures, Pennsylvania’s
Department of Public Welfare (DPW) has instead terminated Medicaid eligibility
for more than 43,400 children since August.  That’s a drop of 3.7%, hardly one that will earn us a bonus.

What this unprecedented decline in children’s enrollment
should earn Pennsylvania is a close look at its enrollment and renewal
processes and procedures and a plan for improvement.  Millions of dollars are available to support that work.  In a state that provides universal
coverage through CHIP or Medicaid for all legally residing children, there’s no
reason for 43,000+ children to be without coverage.

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