Corbett administration seeking assurances state won't be left holding Medicaid bag
HARRISBURG — Pennsylvania's top welfare official will meet with Medicaid's federal overseers on Monday in hopes of getting Republican Gov. Tom Corbett the flexibility he's seeking to determine whether to expand the state's program.
The meeting “is a continuation of ongoing discussions,” said Jennifer Branstetter, Corbett's policy director. “Our team goes into every meeting hopeful that they will have a meaningful discussion around building a program that works for Pennsylvania.”
Beverly Mackereth, the acting secretary of the state Department of Public Welfare, will meet with officials from the federal Department of Health and Human Services, the agency Corbett has been negotiating with to decide whether to expand the health insurance program for low-income people.
Expansion is an option for states under the federal Affordable Health Care Act, often called Obamacare. About half of states tentatively agreed to expand. There's a “misunderstanding” that Corbett, who was one of the attorneys general to unsuccessfully challenge the federal health care law, has rejected expansion, Branstetter said. Corbett was elected governor in November 2010.
Medicaid covers one in six Pennsylvanians. Under the federal health care law, 25 percent of the state's population would be covered if the state opts in. Pennsylvania spends $21.9 billion in federal and state money annually on Medicaid, which serves 2.2 million people. Under the expansion, 500,000 to 700,000 people — some working people whose employers don't provide health care coverage — could be added.
Corbett has said he is holding out until he is persuaded the expansion will be financially sustainable over the long haul for Pennsylvania.
The Washington meeting occurs as Corbett and state legislative leaders attempt to negotiate a budget for 2013-14 by the constitutional deadline of June 30. A budget the House approved last week did not make adjustments for Medicaid expansion because Corbett is negotiating with HHS, said House Appropriations Chairman Bill Adolph, R-Delaware County.
Democrats in the House and Senate, serving in the minority party of both chambers, are calling for Corbett to agree to the expansion.
Unless Corbett agrees to participate, the expansion probably won't happen, political analysts say. While it is “technically possible” for Democrats to garner enough Republican votes for passage, Corbett could veto any bill, said Chris Borick, a political science professor at Muhlenberg College in Allentown.
“The key is the governor coming out and saying, ‘I want it,' ” said Tom Baldino, a political science professor at Wilkes University in Wilkes-Barre. “He has been dragging this out waiting for an answer from Washington.”
Supporters say expansion would provide a state budget savings next year, establish jobs in the heath care sector and provide billions of federal dollars to provide more people with health insurance coverage.
Corbett's administration is concerned that there's no guarantee the federal government in years to come will continue to pay states that expand, and that could leave Pennsylvania taxpayers holding the bag. Moreover, Branstetter said, there is no initial “savings” because of the state's start-up costs.
Rep. Joe Markosek, ranking Democrat on the House Appropriations Committee from Monroeville, disagrees. Without expansion, he says, Pennsylvania is “leaving (federal) money on the table.”
Whether state or federal dollars are spent, it's all taxpayer money, said Matthew Brouillette, president of the Commonwealth Foundation, a conservative policy group.
“The so-called free money coming from Washington is not free at all,” Brouillette said. “It's coming directly out of taxpayers' pockets.”
Average Pennsylvanians don't distinguish between federal and state money since they pay taxes toward both, Brouillette said. “There is no free lunch,” he said.
Sharon Ward, executive director of the Pennsylvania Budget and Policy Center, a liberal-leaning group, rejects Brouillette's argument. “It's kind of irrelevant,” she said, noting there are vast differences between the duties of federal and state governments.
“We pay anyway — in premiums and tax dollars,” Ward said, referring to people without insurance who often are treated in emergency rooms. That's absorbed by hospitals that receive state subsidies called “uncompensated care” to offset the cost, she said.
As the debate over expansion continues, the backdrop is the sharp partisan division among Pennsylvanians.
A Quinnipiac University poll this month of 1,032 registered voters found voters support Medicaid expansion by a 49-44 percent margin. The poll's margin of error was 3.1 percent.
Republicans oppose expansion 73 percent to 18 percent with 9 percent undecided. Democrats support expansion 78 percent to 17 percent with 6 percent uncertain.
“It's now wrapped up with the principle and concept of Obamacare,” Borick said. “Anything with that stamp on it will be highly charged in a partisan way.”
Brad Bumsted is state Capitol reporter for the Tribune-Review. He can be reached at 717-787-1405 and email@example.com.
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- WVa natural gas line explodes near Ohio border
- Grandview development plan inches ahead in Mt. Washington
- Long-term solution for wastewater disposal eludes shale gas industry
- Project to End Human Trafficking volunteers help Uganda
- Storm could drop 4-6 inches of snow on Pittsburgh area
- Mt. Lebanon High School to sell its planetarium equipment
- Catholic Diocese of Pittsburgh nearly doubles goal with $230M pledged in largest fundraiser
- Lure of tuition aid, gifts draw college students to ‘sugar daddy’ sites
- Man arrested in massive Homestead fire
- Tribune-Review photojournalist Goldband wins 1st place in national competition
- Flood victims’ family to receive $1.5M in damages