HARRISBURG, Pa. (AP) – A state hotline jammed up Monday as some of the hundreds of thousands of Pennsylvanians frozen out of the first year of coverage under the 2010 federal health care law’s Medicaid expansion began seeking the insurance.
Many callers to the Department of Human Services’ hotline were met with a recording telling them their call could not be taken because of excessive volume.
Mary Hicks, 48, said she had hoped to apply right away after being unable to hold down a full-time job because of severe sleep apnea that makes it difficult to stay alert during the day or safe to drive in the morning. Hicks, of Murrysville, near Pittsburgh, now works part time in the late afternoon and evenings, making a little more than minimum wage.
“I plan to apply, and I’ve been counting the days,” Hicks said.
Coverage begins Jan. 1, and enrollment is year-round in the program, nicknamed Healthy Pennsylvania by outgoing Republican Gov. Tom Corbett. TV ads have been running as part of a $2.2 million ad campaign by the Corbett administration.
Under the broadening of Medicaid’s income guidelines, childless adults under 65 and earning up to about $16,000 this year are eligible. More parents under 65 also are eligible, depending on their income and number of children.
State officials estimate that about 600,000 adults are newly eligible for the new coverage, although some of those people might already be insured through other programs. Many fell into a gap in which they had too much income to qualify for Medicaid but too little to qualify for subsidized insurance through another element of the 2010 law, the federally run marketplace that began last Jan. 1.
Previously, able-bodied adults under 65 were not eligible for Medicaid, unless they had practically no income. For instance, a single parent of two children making $6,500 a year or less is eligible under the current rules; under the expansion, they could earn up to about $27,000 a year and be eligible.
State officials say they do not know how many people will seek the coverage, and a state Department of Human Services spokeswoman could not immediately gauge enrollment interest Monday.
The expanded federal Medicaid subsidy became available to states in 2014, but it was delayed a year in Pennsylvania because Corbett had sought federal approval to make changes to it. Still, there is little difference between the coverage offered under Healthy Pennsylvania and Medicaid.
Enrollees can choose from Medicaid-funded insurance plans offered by eight insurers across nine geographic regions. The plans carry various co-payments, and not every hospital will accept each insurance plan offered in the region. Sicker people will be moved into a new high-risk plan being offered under in the existing Medicaid program beginning Jan. 1.
Healthy Pennsylvania plans will cover visits to the physician, emergency room and specialists, and prescription drugs. However, the state will not reimburse insurers under Healthy Pennsylvania for dental coverage or renal dialysis, but insurers may offer it anyway.