Briefs & Reports

HMA Q&A: Pennsylvania’s Spin on Medicaid Expansion Stresses Managed Care, Cost Sharing

The Healthy Pennsylvania Medicaid expansion waiver can be summed up as follows: Expansion? Yes. Managed care? Yes. On Exchanges? No. Traditional Medicaid benefit changes? Yes.

More specifically, the compromises that made Healthy PA and its Private Coverage Option possible involve cost sharing, rewards for healthy behaviors and a benefit package intended to mirror commercial health insurance. There are also important changes to benefits under the state’s existing Medicaid managed care program.

In this Q&A, Health Management Associates experts Mike Nardone and Izanne Leonard-Haak discuss the workings of Healthy PA and whether it’s a viable model for other states still considering expansion.