By John Finnerty
Gov. Tom Corbett announced Monday that he would like to skirt Medicaid expansion by funneling federal dollars to offer health insurance to 520,000 low-income Pennsylvanians through exchanges created by the Affordable Care Act.
Corbett hinged his plan on a handful of controversial caveats. These include:
n Benefits for the 2 million Pennsylvanians already enrolled in Medicaid will be tinkered with to save money to offset any increased costs;
n People enrolled in the new plan will have to pay nominal premiums;
n Unemployed people added to the new insurance plan must meet job search requirements; and
n Children enrolled in CHIP, Pennsylvania’s popular children’s insurance program, must be allowed to remain in it.
“If, and only if, the federal government approves Pennsylvania’s plan to reform our existing Medicaid program,” Corbett said, the state would agree to use the federal dollars to provide insurance in the exchanges to people with income up to 133 percent of the poverty level.
“I see no reason (the federal government) shouldn’t go along with it,” Corbett said. “It’s common sense.”
The federal government has already notified Pennsylvania that the children’s insurance program must be folded into Medicaid. And no other state has requested the right to demand that people look for jobs to get health insurance.
Corbett’s plan irked both opponents of Medicaid expansion and proponents who feel that the governor is creating unneeded barriers.
Advocates described the governor’s proposal as a “big step in the right direction.”
But Corbett is still “putting ideology above common sense” by insisting on things like the work-search requirement and the need to shift people into the exchanges rather than Medicaid, said Neil Bisno, president of the SEIU Health Care of PA, a union representing health care workers.
“The quickest, simplest and best way is to expand Medicaid,” Bisno said.
On the other side of the issue, Republicans who oppose Medicaid expansion said no matter where the government-funded health insurance is housed, it’s still a benefit that is contributing to runaway government spending.
“This proposal is almost as bad as doing it exactly how (President Barack) Obama wants us to do it,” said Republican state Rep. Brad Roae of Crawford County.
Roae was one of 30 GOP lawmakers who said in June that they would vote against any 2013-14 budget that included Medicaid expansion.
“The national debt was about $10 trillion when Obama was elected and today it’s almost $17 trillion. Why would we cosign a loan for the federal government?” Roae said. “That is essentially what we would be doing because we know they really cannot afford to pay, so we will end up paying.”
Other Republicans look at it as a more palatable alternative to full Medicaid expansion.
“Today’s announcement by Gov. Corbett is a huge step toward securing that mutual objective, and I applaud him for taking this step,” said Senate Majority Leader Dominic Pileggi, R-Montgomery County. “It would be foolish to leave billions of Pennsylvania tax dollars in Washington, D.C., when that money can be used to expand health care coverage and access to the residents of our state in a fiscally responsible way.”
“I’d rather go this way,” said Rep. Dick Stevenson, R-Mercer County.
Stevenson said he shares the concern that the federal government will not meet its obligations to fully-fund the expansion of health care.
“I’m apprehensive about going down that road,” he said. “Once you start a program, it’s difficult or impossible to stop it.”
Corbett said he does not believe he needs the approval of the Legislature to move forward with this plan. The state Senate voted in favor of Medicaid expansion. The House stripped Medicaid expansion language from the welfare code.
Stevenson said that if Corbett didn’t come up with an alternative, he believes Medicaid expansion would eventually pass in the House, as well.
Finnerty works in the Harrisburg Bureau for Community Newspaper Holdings Inc. He can be reached by email at firstname.lastname@example.org or on Twitter @cnhipa.