Pennsylvania Gov. Corbett might allow Obamacare expansion, but not without concessions

(PennLive) Gov. Tom Corbett might expand Medicaid as called for in the federal Affordable Care Act. But not unless the federal government gives in.

“At this time, without serious reforms, it would be financially unsustainable for Pennsylvania taxpayers, and I cannot recommend a dramatic Medicaid expansion,”stated a letter the Corbett administration said was sent to federal officials on Tuesday.

Corbett’s letter also states, “I want to be clear, I firmly believe we can serve more of our citizens in Pennsylvania, but only if we are given the flexibility and independence to do do.”

Excerpts from the letter released to the public don’t detail specific reforms sought by Corbett, who did say the growth of the existing Medicaid program is unsustainable for Pennsylvania.

Medicaid is the program that covers health care for the poor. The cost is split roughly 50-50 between states and the federal government.

The Affordable Care Act, widely known as Obamacare, calls for expanding Medicaid to include people earning up to 133 percent of the federal poverty level, which is about $15,000 for an individual and $31,000 for a family of four.

The expansion, which would begin on Jan. 1, 2014, is expected to cover more than 600,000 presently uninsured Pennsylvania residents.

The federal government has promised to cover 100 percent of the benefit costs of the expansion through the end of 2016, with the federal share then dropping slightly each year to 90 percent in 2020 and thereafter.

Supporters of the expansion say it would bring $4 billion per year in federal funds to Pennsylvania.

However, Corbett says the expansion would cost Pennsylvania $367 million in 2013-2014, with the state’s share rising to $1.2 billion in 2020-2021. “Without reform, the only way to support these costs would be a large tax increase on Pennsylvania families,” Corbett said.

According to a fact sheet released by the Corbett administration, the expansion also would result in one in four Pennsylvania residents being covered by Medicaid.

Supporters of the expansion argue that taxpayers are already paying in the form of costs that get shifted from hospitals to health insurance premiums, and tax dollars that help cover uncompensated medical care.

One supporter, Sharon Ward of the Pennsylvania Budget and Policy Center, said, “The governor’s short-sighted decision to reject an opportunity to expand health coverage through Medicaid to more low-income working people is a departure from other Republican governors in states like Arizona and Ohio. One of the best ways to reduce health care costs is to expand health coverage so that fewer people are showing up in ERs with serious and expensive illnesses. Research studies have also concluded that Medicaid improves health outcomes.”

But the Hospital & Health System Association of Pennsylvania, another prominent supporter of the expansion, had no criticism of Corbett’s approach, which became known on when he released his proposed 2013-2014 budget Tuesday.

“Understanding the federal challenges outlined by the Governor today regarding Medicaid, the hospital community looks forward to working with the administration and the General Assembly in the coming months to keep hospitals strong and to expand health insurance coverage to additional Pennsylvanians in need,” HAP said.

HAP has said it’s costing Pennsylvania hospitals $1 billion a year to care for people who can’t afford their medical care, and the survival of some hospitals depends on the expansion.

State Sen. Pat Vance, R-Cumberland, said she wasn’t surprised that Corbett had decided to have the state opt out of Medicaid expansion, and the federal government has “been incredibly short on specifics.”

But prominent Democratic House member Dan Frankel of western Pennsylvania stressed that several Republican governors have said they will carry out the expansion.

“Governor Corbett chose to pander to the far right and willfully inflict damage on Pennsylvania’s economy — he has undermined any promises he makes about jobs. Accepting federal funds for expansion would be a great economic driver in Pennsylvania by allowing for the creation of potentially thousands of quality, good-paying jobs in the health care sector,” Frankel said.

As of early last week, 17 states and the District of Columbia had said they would accept the federal funds and carry out the expansion, the Associated Press reported. That included three led by Republican governors.