Healthy Pennsylvania v. Healthy Michigan

According to Pennsylvania’s 2013 Medicaid “ACA-MA_Expansion_Sheet,”   The expansion of the Medicaid program, as proposed in the Affordable Care Act, would expand eligibility for Medicaid to all adults between 19 and 64 who are at or below 133% of the federal poverty level (FPL).  The expansion would add over 800,000 – more than 643,000 adults and 161,000 children.”  Instead of celebrating the fact that so many people in poverty would receive health care at federal expense, Governor Tom Corbett’s administration adopted a niggardly policy of opposing the expansion.  Only when it became clear that public opinion overwhelmingly supported Medicaid expansion did Corbett change course – from due south to south by south by southwest.  This is a fitting simile for a Rick Perry wannabe.

The new Corbett Plan, called Healthy Pennsylvania with no intended irony, would provide some coverage through private insurers, but require health-care premiums starting at the Federal Poverty Level and punish anyone who missed three months’ payments.  The Corbett Administration and its legislative caucus have no concept of how difficult it is to survive on minimum wage.  The poverty level for a one-person household is $11,490.00.  Full-time employment at the federal minimum wage ($7.25) is $15,020.00, gross.  At that income level, even a modest premium payment will often represent the difference between eating and going hungry.  A similar plan was tried in Oregon, but failed miserably.

The Corbett Plan also violates the Affordable Care Act by requiring enrollees to demonstrate involvement in work-search and job-training activities.  How do you even say, “Pennsylvanians will turn down employment to qualify for Medicaid,” with a straight face?  A huge majority of the new enrollees will be the working poor: those who are stuck in minimum-wage jobs.

Michigan, on the other hand, is implementing legitimate Medicaid expansion.  Effective April 1, 2014, Michigan will implement the Healthy Michigan Plan.  It will be administered by the Michigan Department of Community Health, Medical Services Administration, as authorized under the Affordable Care Act of 2010, and 2013 Michigan Public Act 107.

Governor Rick Snyder’s Healthy Michigan, as described in a Department of Community Health Bulletin, authorizes coverage for Michigan residents between the ages of 19 and 64, who have income at or below 133% of the federal poverty level, unless they are qualified for Medicare or Medicaid or are pregnant.  It does not require payment of a premium for those who qualify.  Pregnant women would be eligible for coverage under another, more generous, state program.

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This is extremely important for the low-income working men and women.  Under Medicaid Expansion, it will not be necessary to demonstrate permanent disability to qualify for medical coverage.  Prior law required that a person meet the Social Security definition of permanent disability – that the individual is unable to engage in substantial gainful activity and that the disability is expected to last for a year or more.  This meant that a person with a disability that could be corrected by surgery would not have a disability expected to last a year or more.  On the other hand, the person could not get coverage for the surgery to remedy the disability, so they might be unable to work for years.

Michigan has made a major improvement in the lives if her less-fortunate residents.  Hopefully those states, like Pennsylvania, that are clinging to an unfair heritage will get on board with the ACA.


John B. Payne, Attorney
Garrison LawHouse, PC
Dearborn, Michigan 313.563.4900
Pittsburgh, Pennsylvania 800.220.7200
©2013 John B. Payne, Attorney

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