Health and Family Security

Later this week or next we should get a CBO score of the latest Senate health care bill and we will revise, once again, our projections for its impact on Pennsylvania. But, we are not expecting major changes in anything but in how long it takes for well over a million fewer Pennsylvanians to have insurance as a result of the bill. To see why, one must step away from some of the details of the bill and look at the big picture, focusing not just on the policy but the politics of the bill. 

From that perspective, it is pretty obvious why the Republican approach to repealing and replacing the ACA – and drastically reducing the size of the Medicaid program – can’t be fixed. 

The Manatt Health Group and the Robert Wood Johnson Foundation have released a new study of the impact of the Senate health care bill, the Better Care Reconciliation Act of 2017, on the states. Their estimates of the impact of the bill confirms our recent study showing that Pennsylvania will suffer devastating reductions in federal funding for Medicaid. It also offers some more fine-grained detail on the nature of these reductions.

Pennsylvania must brace itself for a substantial decrease in federal Medicaid payments that would devastate our state budget and cause massive losses in Medicaid coverage as the Senate moves to pass a version of the House’s American Health Care Act. Under the leadership of Pennsylvania’s own junior senator, Pat Toomey, that version of the bill has significantly deeper cuts to Medicaid than the House bill. 

In his budget address, Governor Wolf observed that Pennsylvania faces a choice of two paths. Taking one path would require us to deal with the reality of our structural deficit and raise revenues to close it. It would enable government to continue to meet its responsibilities to educate our children, serve those who need our help, protect the environment and encourage economic growth. Taking the other path would require us to accept devastating cuts to education and health and human services.

The ideas in this document were compiled by the Pennsylvania Budget and Policy Center based on our own work and that of our partner, the Keystone Research Center, and that of advocates on many issues. The names of our partners are in our letter to the Governor and the members of the General Assembly.

Budget numbers are always difficult to understand, not least because those with different perspectives can present the numbers in sharply different, but honest ways. In the context of the state’s still-unfinished 2105-16 budget, this brief presents a series of careful “apples-to-apples” comparisons of the three budgets in play in Harrisburg last year: Governor Wolf’s budget proposal, the Republican budget and the bi-partisan budget agreed to by Governor Wolf and the leaders of the Democratic and Republican parties in the General Assembly.

As of December 10, 2015, the 2015-16 Pennsylvania Budget is still not done. Two different budgets are now before the General Assembly. In this brief, we provide an overview of the differences between the two budgets, looking first at critical differences in spending for education and human services, then at the impact of those differences, and finally at some subtleties in how the two budgets organize  and present certain spending choices they have in common and how this affects the bottom line budget numbers

October 14, 2014

The Department of Public Welfare (DPW) will end family planning coverage for almost 90,000 low income women currently enrolled in SelectPlan for Women, most of whom will be eligible for comprehensive health care coverage through Healthy Pennsylvania. Rather than ending the SelectPlan waiver, DPW should transition eligible SelectPlan enrollees into Healthy Pennsylvania and continue to offer SelectPlan as a choice for women who are not Medicaid expansion-eligible.

Monthly archive