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Despite GOP skeptics, Democrats intensify push for Medicaid expansion in Pa.

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Thursday, June 20, 2013, 3:48 p.m.

HARRISBURG — After months of talking with the Corbett administration about expanding Medicaid, a federal official in the agency overseeing the program said Thursday he could not predict how close they are to agreement.

Democrats in the state House and Senate are pushing Republican Gov. Tom Corbett to join the program as the 2013-14 budget is adopted by June 30.

Paul Dioguardi, director of intergovernmental affairs for Health and Human Services, said Pennsylvania “would greatly benefit” by joining.

The top Republican state senator says a bill to expand Medicaid eligibility will come up for a floor vote next week.

Senate President Pro Tempore Joe Scarnati said Thursday that Republicans will prepare legislation that puts reasonable conditions on an expansion. An expansion would cover hundreds of thousands of uninsured adults.

Scarnati says one condition could require that children covered by the Children's Health Insurance Program cannot be forced by the federal government to switch into Medicaid.

The government offered states “a very favorable deal,” Dioguardi said — it will pay 100 percent of expanded costs for three years and at least 90 percent after that.

In Pennsylvania, that could extend coverage to about 600,000 low-income people, Dioguardi said.

It would pump federal resources into the state, estimated at $2 billion annually in a Rand Corp. study, and help reduce “uncompensated care” for which the state subsidizes hospitals and health care facilities that treat people without insurance, he said.

A Corbett spokeswoman said the administration continues to work with the federal agency.

“We're committed to continuing discussions ... and hope that HHS will keep an open mind to innovation and flexibility so that we can build a program that works for our residents,” said Corbett's spokeswoman, Christine Cronkright. “We ultimately will not be forced into a one-size-fits-all program because it is consistent with Washington's goals.”

Cronkright noted that HHS said if federal funding decreases, Pennsylvania could opt out at any time.

“This is troubling policy and is not what citizens should expect,” she said. “We believe it's common sense to build a sustainable program.”

Dioguardi said HHS is not aware of any public proposal from Corbett's aides or a plan before the Legislature. The state Department of Public Welfare has spelled out concerns in letters to the agency.

About half the states agreed to participate in the expanded Medicare program under the Affordable Care Act.

Acting state Health Secretary Beverly Mackereth on Monday met with HHS officials. She and other Corbett aides have pushed for flexibility on issues such as cost-sharing and job training.

U.S. Rep. Joseph Pitts, R-Chester County, who chairs a congressional subcommittee studying Medicaid expansion, cautioned against it in testimony on Thursday before a state House Health Committee in Harrisburg.

“Medicaid is already in deep trouble, and expansion is going to make it worse,” Pitts said. “When someone already $17 trillion in debt promises to pay 90 percent of a hugely expensive new program, you should be very, very skeptical. When the inevitable happens, the state General Assembly will be left holding the bag.”

Drew Gonshorowski, a policy analyst for the conservative Heritage Foundation, said Medicaid expansion for most states “will begin to cost the state once match rates are reduced from 100 percent” after three years.

Democratic state Rep. Dan Frankel of Squirrel Hill called the House Health Committee hearing a sham that was stacked with expansion opponents.

Brad Bumsted is Trib Total Media's state Capitol writer. The Associated Press contributed to this report.

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