By John Finnerty
The state must hire at least 720 workers to handle the influx of people signing up for expanded Medicaid benefits, according to Corbett administration officials who’ve complained about costs associated with the federal Affordable Care Act.
Most of those workers will be assigned to county offices where they will enroll an estimated 500,000 Pennsylvanians who are expected to be eligible for Medicaid under the act, said Eric Kiehl, a spokesman for the Department of Public Welfare.
Kiehl said the state needs the extra help regardless of whether it directly expands Medicaid under the new federal health insurance law or if it’s allowed to pursue an alternative to Medicaid expansion that Gov. Tom Corbett has proposed to the federal government.
The department doesn’t expect to be reimbursed for all costs related to the new workers, Kiehl said, despite assurances that the government will handle the initial expense of Medicaid expansion. Costs include pensions given to the new workers, who will be state employees, he noted.
“Taxpayers will be footing the bill for their payroll costs,” Kiehl said, “and taxpayers will be footing the bill for their pensions.”
The Department of Public Welfare expects to hire 606 caseworkers, supervisors and support staff in county offices, and another 114 administrative staff in Harrisburg, he said.
Budget Secretary Charles Zogby said last week the state’s workforce will increase by 140 positions in the budget year that begins July 1 under Corbett’s version of Medicaid expansion. That number reflects the elimination of 600 jobs in other agencies that will largely offset the new Welfare Department workers, he said.
Since Corbett took office, the state has cut the number of state employees by 3,000, Zogby said.
The state expects to spend $39 million in the coming year on administrative costs related to the Affordable Care Act, Kiehl said.
Corbett has resisted the Affordable Care Act, first by refusing to set up a state-run health insurance exchange. He has since asked the federal government to allow the state to enroll new Medicaid beneficiaries in the private exchanges created under the act. Those exchanges were originally intended to provide alternatives for people who can’t get health care coverage at work.
A spokesman for Sen. Vincent Hughes, D-Philadelphia, a leading proponent of Medicaid expansion at the Capitol, said there’s no question the state will need to hire people. But Hughes’ spokesman Ben Waxman said savings from expanded Medicaid — on top of federal spending to provide health care coverage — should more than offset the administrative costs.
The state’s Independent Fiscal Office reported that Medicaid expansion will save the state $400 million by shuffling people from state-funded programs into the federal program.
“The reality is, there are tremendous benefits from Medicaid expansion, and they just gloss over them to blame the federal government for these costs,” Waxman said. “We can agree that it’s going to take additional people. The Department of Public Welfare is already understaffed, and we are talking about providing health care coverage to 500,000 people.”
New state workers won’t be the only ones finding jobs because of the Affordable Care Act. Nonprofit organizations in the state have hired hundreds of health care navigators to help people sign up for insurance.
The Pennsylvania Association of Community Health Centers hired and trained 201 navigators for 170 locations throughout the state, said Jim Willshier, the association’s director of policy and partnership. Its health centers have reported enrolling 2,268 people for coverage, though only half of the centers have reported how many people they’ve assisted, he said.
The federal government has tapped three other groups in Pennsylvania to help people find insurance through the exchanges, as well.
The state’s initial analysis predicted that more than 2 million uninsured Pennsylvanians would be eligible for insurance through the exchanges. But as of the end of 2013, just 81,000 Pennsylvanians had signed up for health coverage on the exchanges.
The U.S. Department of Health and Human Services has spent about $35 million to roll out the exchanges in Pennsylvania, according to Enroll America, one of the groups hiring navigators in the state.
Even while the expansion of health insurance creates nonprofit and government jobs, business groups warn the private sector is suffering. Those fears were supported last week by a Congressional Budget Office analysis that the Affordable Care Act could drive 2.5 million Americans out of work because they’re now holding onto jobs to get insurance.
Business groups also warn that some of the act’s requirements will force small businesses to cut worker hours or otherwise cut costs.
Todd Brysiak, a spokesman with the Pennsylvania Chamber of Business and Industry, said most businesses fear their health plan costs being driven up “dramatically.”
“Most of our members are small employers with razor thin margins,” Brysiak said.
Among the most worried, he said, are those who will be subject to a 50-employee mandate that begins Jan. 1, 2015. Under that rule, an employer with 50 employees must provide a minimum level of health insurance. If a company doesn’t and any of its employees get insurance through a health exchange, that business will be hit with a $2,000 per employee penalty.
John Finnerty reports from the CNHI Harrisburg Bureau for The Meadville Tribune and other Pennsylvania newspapers owned by Community Newspaper Holdings Inc. Email him at firstname.lastname@example.org and follow him on Twitter @cnhipa.