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In 2011, people protested outside Gov. Tom Corbett's home as he ended a program that provided low-cost health insurance to about 41,000 people. On Jan. 1, 2015, many of those people and hundreds of thousands more will be eligible for coverage under a new Corbett program that is receiving a cold shoulder from Democrats.

(David Wenner, PennLive)

If you've needed medical care but couldn't afford it, 2015 looks like your year.



On Monday, hundreds of thousands of uninsured Pennsylvanians can begin signing up for low-cost health insurance through Gov. Tom Corbett's version of the Obamacare Medicaid expansion.



Those who sign up soon can be covered on Jan. 1.



The program, called HealthyPA, dovetails with other coverage available via the Obamacare exchange, which covered 318,000 Pennsylvanians in 2014, and which is expected to cover still more in 2015.



Together, the programs are expected to make a major dent in Pennsylvania's uninsured population, which has reached 1.2 million in recent years.



"We can't emphasize enough the positive impact this will have," said Antoinette Kraus, executive director of the Pennsylvania Health Access Network, which advocates for people with lower incomes and without insurance. "I think we'll drastically see the number [of uninsured people] decrease, because now there's pretty much a pathway for everyone to get coverage."



The new program is for people earning up to 138 percent of the federal poverty level, which is about $16,000 for a single person, $22,000 for a couple and $33,000 for a family of four.



People in this group, which Kraus believes numbers about 300,000, earn too much to qualify for the old Medicaid program, but not enough to afford the subsidized coverage that became available through the Obamacare exchange at the beginning of 2014.



The Corbett administration estimates the new program can provide coverage for 600,000 people, although a portion of those will be moved out of other programs.



People can find out more and enroll at www.healthypa.com or apply by phone at 1-866-550-4355 or apply at their local county assistance office.



Not surprisingly, politics will impact and possibly undermine the newly available coverage.



That's because Corbett's version is different than the Medicaid expansion prescribed by Obamacare, and favored by Democrats including Pennsylvania's Gov.-elect Tom Wolf.



Corbett's version involves using the Obamacare expansion funds to provide private health insurance and to impose cost-sharing and employment-related requirements that aren't part of the Obamacare version.



Advocates and Wolf say the Corbett version is bureaucratically cumbersome, and the cost sharing will be detrimental.



Wolf has asked the Corbett administration to cease implementing HealthyPA, and says he will switch back to the straight Medicaid expansion.



The Corbett administration has refused, saying it must forge ahead, so coverage can be available to hundreds of thousands of people beginning Jan. 1.



Absent cooperation from the Corbett administration, any Wolf-sought changes would have to take place after Jan. 20, when he takes office.



Officials within the Pennsylvania Department of Human Services, which is carrying out Corbett's program, have said making changes abruptly will threaten benefits for hundreds of thousands of people. Given that Corbett's plan makes changes to the state's present Medicaid program, disruptions could impact new and old program users.



DPW officials have said they have carried out extensive technological changes and stressed that health benefit enrollment is entwined with enrollment for additional programs, such as cash assistance, food stamps and heating assistance.



"Everything is tied together," said DHS Secretary Bev Mackereth, who also cited potential for "disruptions" for hundreds of thousands of people, if Wolf makes abrupt changes.



Word emanating from the Wolf camp is that Corbett could prevent disruptions by pulling the plug on his program, presumably allowing straight Medicaid expansion to occur by default.



But it's hard to get a definite answer on whether coverage would be available on Jan. 1 if Corbett pulls the plug, or whether a train wreck will occur after Jan. 20 if Wolf reverts to straight Medicaid.



DHS spokeswoman Kait Gillis said in an email,

"The Healthy PA approach to Medicaid reform and the private coverage option plans were agreed upon by the federal government ... We have made all necessary technological changes to be prepared this enrollment start and it is imperative that we continue toward the Jan. 1 implementation date in order to provide timely access to health care coverage for all eligible Pennsylvanians – which has been our goal throughout the entirety of this process."

A spokesman for the federal Centers for Medicare & Medicaid Services didn't shed much light, stating in an email: "Any state can work with CMS to change the terms of an approved waiver. I can't speculate beyond that."

Kraus, the advocate for people without uninsured, said she would prefer to see the Corbett administration immediately begin working with Wolf on transitioning to the program Wolf prefers.

But regardless, she said advocates are urging the uninsured to ignore the politics and sign up for coverage on Monday. She also moves forward with the belief that, whatever the actions by Corbett and Wolf, people can get coverage and face no major disruptions beginning Jan. 1.

Note: this story was revised to reflect that the Pennsylvania Department of Public Welfare is now called the Pennsylvania Department of Human Services, or DHS.