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Battle to expand Medicaid in Pa. likely to flare soon

Welfare facts

• Pennsylvania's Medicaid program, which provides insurance coverage for 2.2 million low-income residents, spends about $21.9 billion each year in state, federal and other funds.

• Total Medicaid spending accounts for 73 percent of the state Department of Public Welfare's budget and 27 percent of the General Fund budget.

• Pennsylvania ranks second in the nation for the percentage of the state's General Fund going toward Medicaid spending.

• The Department of Public Welfare, which oversees Medicaid, employs 16,000 people.

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Sunday, June 2, 2013, 10:30 p.m.
 

HARRISBURG — Jack Treadway has a doctorate in political science but doesn't have the foggiest idea who is right on the issue of expanding Medicaid in Pennsylvania.

Treadway hears the arguments from both sides and sees a dizzying array of numbers — from advocates who contend it would mean billions more dollars in federal aid and would provide insurance coverage to 500,000 to 700,000 uninsured people, to Gov. Tom Corbett, who says state taxpayers can't afford it and could be left holding the bag if federal money dries up.

The numbers “are so disparate you can't reconcile them, even a little bit,” said Treadway, a retired Kutztown University professor.

Democrats in the Legislature are pushing for the expansion, saying it would provide $180 million more for the 2013-14 budget. Corbett administration officials suggest that number is wrong and that long-range predictions are too optimistic.

It's a choice states were given under President Obama's Affordable Care Act. About 26 states have agreed to take the money; 13 states, including Pennsylvania, said no. The remaining 11 are undecided, according to the Advisory Board company, a global research and consulting firm.

The push for Medicaid expansion likely will intensify during the second half of June as lawmakers and the governor attempt to agree on spending priorities within a $28 billion budget.

Senate Democrats are poised to use a parliamentary maneuver to force a vote on expanding Medicaid.

On Monday, Senate Democrats will present their version of a budget, which likely will include Medicaid expansion.

Senate Minority Leader Jay Costa, D-Forest Hills, believes there's a shot at getting three moderate Republicans to side with Democrats and provide 26 votes to force Medicaid expansion.

Three studies, including one by the state's Independent Fiscal Office, show a clear financial gain for the state and more jobs, Costa said.

Expanding Medicaid would create 41,000 jobs, according to a study by Families USA.

Costa contends that the evidence is overwhelming.

Corbett's office says otherwise.

“Aside from covering the mandatory services required by the federal government under the program, Pennsylvania also covers 29 other optional services, such as dental and chiropractic services, hearing aids, eyeglasses, hospice, psychologist and podiatrist services,” said Corbett's spokeswoman, Christine Cronkright. “As more and more options have been layered on top of the program, it's become much more than originally intended — a tailored program for our neediest citizens. We need to ensure we can sustain the program for our neediest citizens now and well into the future.”

Re-election issue?

With Corbett facing re-election next year, his position on not expanding Medicaid likely will become a campaign issue. Corbett hasn't ruled out agreeing to the expansion if the Department of Health and Human Services grants states more flexibility in administering the program.

Asked about Corbett's argument that federal money could be discontinued, Democrat John Hanger, a potential gubernatorial challenger, said: “We might get hit by a meteor, too.”

A debate over Medicaid expansion within the context of national health care “may be a bit esoteric” to affect the governor's race much, Treadway said. Moreover, neither Obama's health care law nor Medicaid are overwhelmingly popular programs with the public, he said.

Voter positions appear to be hardened along partisan and ideological lines. A poll by Harper Polling this year showed that nearly 67 percent of Republicans oppose expanding Medicaid, and 80 percent of Democrats support it.

“The problem is, I think, that most people don't understand (Medicaid),” said Jerry Shuster, a professor of political communications at the University of Pittsburgh.

But Corbett's popularity is low, and failing to expand Medicaid will be fodder for opponents who could contend his decision “is one more shot at the poor and the elderly,” Shuster said.

Brad Bumsted is state Capitol reporter for the Tribune-Review. He can be reached at 717-787-1405 or bbumsted@tribweb.com.

 

 

 
 


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