New Welfare Department chief in middle of Pa.'s Medicaid debate
HARRISBURG — When she got the offer, Beverly Mackereth wasn't sure she wanted to take the reins of the state's largest agency.
But the former York County legislator said she couldn't say no to Gov. Tom Corbett, who asked her to become acting secretary of the Department of Public Welfare. A former mayor of Spring Grove and the mother of four adult children, Mackereth was a deputy secretary in February when she agreed to do the job.
Two weeks later, she was thrust into legislative budget hearings. Now the department is at the epicenter of a decision with enormous long-range implications for the state: whether to expand Medicaid under President Obama's health care overhaul. Like all states, Pennsylvania must decide whether to accept the offer of increased federal money for state-run Medicaid programs now, with the federal funding falling off in years to come and the states having to make up the difference. Republican governors, including Corbett, draw increased attention because of the party's opposition to Obama's program.
Mackereth, Corbett and other Pennsylvania officials met last week in Washington with Health and Human Services Secretary Kathleen Sebelius.
“It's overwhelming at times,” Mackereth acknowledged about overseeing the department. “I take it a day at a time; actually, a minute at a time.”
After eight years in the state House, she was accustomed to the spotlight. That helped her prepare for running the agency with 16,000 employees — more than the population of Greensburg or New Kensington or Jeannette.
On Monday, she will speak at the Pennsylvania Association of County Human Services Administrators' spring meeting in Harrisburg about the budget and the Medicaid issue.
With a $28.4 billion budget that is the same size as Pennsylvania's general fund budget, the department Mackereth runs essentially is a government within a government. The Medicaid program, which provides health care for 2.2 million low-income people in Pennsylvania, alone accounts for 27 percent of the state budget.
Under the Affordable Care Act, Pennsylvania could get billions more in federal aid for Medicaid. But Corbett's office is wary of long-term costs to state government to support the expanded program. Medicaid has grown 8 percent annually, providing care to one of every six Pennsylvanians, Mackereth said.
If the program expands, one in four Pennsylvanians would receive Medicaid, increasing enrollees to 3 million, she said.
Corbett wants Medicaid changes that would give Pennsylvania more flexibility.
On balancing increased federal aid and state costs, Mackereth said: “We can't have that discussion yet. We have to reform our current structure.”
Sebelius' effort impressed Mackereth, who said federal officials have been forthcoming with answers.
“The idea they are not sharing is inaccurate. The information they are giving is general and not specific to Pennsylvania,” she said. “I think their goal is the same as ours: to provide access to more people and provide quality affordable health care.”
Sebelius seemed surprised when told that Medicaid accounts for more than a quarter of Pennsylvania's budget, Mackereth said.
Although the state budget deadline is June 30, Mackereth said no one has set a timeline to resolve the Medicaid question.
“We can't have a deadline and do this the right way,” she said.
One of many issues state and federal officials discussed was the Children's Health Insurance Program, or CHIP. Pennsylvania established the first program in the nation for uninsured youths in 1992, with the intention of covering children not covered by Medicaid.
State officials want to know whether Pennsylvania could keep that program, Mackereth said. Preliminarily, federal officials “said they believe it's a ‘no,'” she said, though state officials don't know how that would affect Pennsylvania.
Corbett, Mackereth said, repeatedly emphasizes taking it step-by-step and “doing it right.” And after a long career in human service agencies and child protection, she said her plan is to help make that happen.
Brad Bumsted is state Capitol reporter for Trib Total Media. Reach him at 717-787-1405 and firstname.lastname@example.org.