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Corbett's Medicaid gambit

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Saturday, Sept. 21, 2013, 9:00 p.m.
 

HARRISBURG

Not since Harris Wofford's 1991 race for U.S. Senate emphasizing “national health care” has a health care issue — now Medicaid — potentially defined a statewide race. In this case, it's Gov. Tom Corbett's 2014 bid for re-election.

Wofford made up a 40-point gap in the polls to defeat former Gov. Dick Thornburgh. Wofford, a Democrat, never made clear how the program would be funded but Thornburgh was caught flat-footed in the special election campaign, which foreshadowed Bill Clinton's victory in the presidential race the following year.

Medicaid won't be the focal point in the governor's race like national health care was in 1991. But it will be a key issue nonetheless.

Rather than flat-out expand Medicaid as states are allowed to do, Corbett last week proposed a two-tier approach using federal money from the program to buy commercial insurance rather than add the uninsured to welfare rolls while making substantial cost-saving changes to the state's existing Medicaid program.

Critics on the left said it was too little too late after he let a program for the working poor (adultBasic) expire in 2011. Those firing from the right claimed it was still “an expansion of the welfare state,” as Rep. Daryl Metcalfe put it. Metcalfe, R-Cranberry, called it a “shell game” because it is still using tax dollars — federal tax money, not state. The flip side of that is if Pennsylvania doesn't accept any money, state taxpayers' federal tax payments will pay for health care in other states.

Corbett, a Shaler Republican, said it was not Medicaid expansion. But others claimed that was semantics. Clearly, it is expansion of taxpayer-paid health care for low-income people.

Corbett's negotiations with the Obama administration have been underway since January. Waiting till now might fend off a challenge from a conservative in next year's GOP primary. It's technically not too late. But only a self-funded GOP candidate could likely be a formidable challenger.

If Corbett's plan is rejected by the Obama administration, he can argue he tried to get the best deal for Pennsylvania taxpayers but Obama wouldn't go for it. A recent USA Today and Pew Research Center poll found Americans oppose ObamaCare 53-42 percent. So it's not like Corbett is disrupting provisions of a highly popular program.

Taking ObamaCare as is would increase the proportion of Pennsylvania's population on Medicaid from one in six to one in four, the Corbett administration contends. It now costs $19 billion annually in state and federal money.

If his plan is rejected, that could hand an issue to a Democrat challenger who could argue Corbett blew it and lost hundreds of millions of federal dollars. That depends who the Democrat nominee is and how much campaign money he or she has to get out that message.

Brad Bumsted is the state Capitol reporter for Trib Total Media (717-787-1405 or bbumsted@tribweb.com).

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