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Pennsylvania governor offers Medicaid plan

By Marc Levy

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HARRISBURG, Pa. (AP) — Pennsylvania Gov. Tom Corbett will become the 10th Republican governor Monday to publicly support bringing federal Medicaid expansion dollars to their states in a bid to extend health insurance to hundreds of thousands of working poor.

Corbett, who was expected to make the announcement after a brief afternoon tour of Harrisburg Hospital’s emergency room, is a conservative and a staunch critic of Medicaid who sued to overturn the Patient Protection and Affordable Care Act (PPACA).

Corbett will insist that the deal he is seeking — similar to one already being sought by Iowa and Arkansas — does not amount to a Medicaid expansion. Under that format, the PPACA Medicaid expansion dollars would pay the premiums for newly eligible adults to get private insurance in a new health care marketplace instead of being used to expand the tradition Medicaid coverage that typically pays lower reimbursements to doctors and hospitals.

Corbett’s embrace of the money comes after heavy pressure by a broad coalition of Democratic lawmakers, labor unions, hospital executives, advocates for the poor, the NAACP, the AARP and the Republican-controlled state Senate. Critics say he has dragged his feet on the issue for too long.

The federal Medicaid expansion dollars become available Jan. 1. But it is not yet clear whether the Obama administration will agree to Corbett’s conditions, and the Corbett administration has yet to submit a request for approval to U.S. Department of Health and Human Services. In addition, Corbett’s public welfare secretary, Beverly Mackereth, has said that the administration will probably need until 2015 to negotiate and prepare for a Medicaid expansion plan, even if Pennsylvania agrees to accept the dollars.

Questions surrounding that kind of plan include who will pay the difference if private insurance policies are more expensive than Medicaid coverage, how to administer such a concept and how those private plans will reflect Medicaid guarantees of certain benefits and limits on cost-sharing, said Matt Salo, executive director of the National Association of Medicaid Directors in Washington.

Supporters of an expansion were wary ahead of Corbett’s announcement, calling it a step in the right direction, but questioning whether Corbett was really committed to accessible and comprehensive health care for the poor.

“It is really unfortunate that … we’ve had to bring this governor kicking and screaming to do the right thing for hardworking Pennsylvanians,” said Neil Bisno, the president of SEIU HealthCare Pennsylvania, which represents public and private-sector health care workers.

The 2010 federal health care law had required states to go along with the Medicaid expansion as a way to ensure more residents have health insurance and that hospitals see fewer uninsured patients and need less financial assistance. However, the U.S. Supreme Court ruled last year that the federal government could not force states to expand Medicaid, effectively making it a state-by-state decision.

Other Republican governors who support a Medicaid expansion include those in neighboring states: Chris Christie in New Jersey and John Kasich in Ohio.

Corbett, who is unpopular in public opinion polls as his 2014 re-election campaign gears up, is heavily criticized by Democrats and advocates for the poor for his health care policies. Since he became governor in 2011, enrollment in both Medicaid and the Children’s Health Insurance Program has shrunk, while he shut down a state-subsidized health care program called adultBasic for about 40,000 lower-income adults.

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