On Aug. 28, the Centers for Medicare and Medicaid Services (CMS) approved Pennsylvania’s application for a Medicaid demonstration titled Healthy Pennsylvania that expands Medicaid eligibility to a new group of adults. With Healthy Pennsylvania, CMS granted the state a waiver of certain federal requirements that would otherwise apply to the Medicaid program. The demonstration is effective Jan. 1, 2015, for a five-year term ending Dec. 31, 2019.
Background
The Patient Protection and Affordable Care Act of 2010 (ACA) provided that states must expand Medicaid eligibility to most adults under age 65 earning less than 138 percent of the federal poverty level (FPL) or they would forfeit federal Medicaid funding. However, in the 2012 decision National Federation of Independent Business v. Sebelius, 567 U.S. ___ (2012), the U.S. Supreme Court held that the threat of withholding all federal Medicaid funding was unconstitutionally coercive and that states must be given the choice of whether to expand Medicaid.
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