Gov. Corbett's cures for Medicaid to test GOP, feds
By Brad Bumsted and Alex Nixon
Published: Saturday, Sept. 14, 2013, 9:00 p.m.
HARRISBURG — Gov. Tom Corbett, a Republican holdout on expanding Medicaid under the Affordable Care Act, on Monday will outline a hybrid plan of using federal money to buy commercial insurance for the poor.
If federal regulators approve, Corbett would be able to address the issue of insuring low-income Pennsylvanians and possibly improve low approval ratings in public opinion polls as he prepares to campaign for re-election, analysts said. Complying with Medicaid expansion, even under negotiated terms, would bring the state billions of federal dollars, potentially quieting some of the governor's Democratic critics.
Corbett has been asking the Health and Human Services Department to approve work requirements and some premiums for Medicaid recipients. He has cautioned that state taxpayers can't afford to expand the program to 800,000 uninsured residents if federal money runs out.
Additionally, he will detail general health care measures he believes would benefit Pennsylvania but need approval from the state Legislature.
Corbett is “opening the door” to Medicaid expansion, said Joseph DiSarro, chairman of the political science department at Washington & Jefferson College. He will float “a trial balloon. He wants to see how the (Republican) Party reacts,” DiSarro said.
Twenty-two states, most led by Republican governors or GOP-dominated legislatures, won't open their Medicaid programs to more people. Twenty-three states will accept federal money to expand enrollment.
The idea of using taxpayer money to buy coverage from private insurers is similar to plans Arkansas, Iowa, Indiana and Oklahoma are pursuing. Corbett's policy director, Jennifer Branstetter, insists his proposal is not Medicaid expansion.
Medicaid provides health coverage for 2.2 million Pennsylvanians. It accounts for about 27 percent of state spending.
A 2012 Supreme Court ruling that upheld the Affordable Care Act allowed states to decide whether to expand Medicaid with additional federal money. A key component of Corbett's plan, aides say, is using that money to buy insurance for those in need.
DiSarro, a conservative Republican, said the GOP lost the battle over so-called Obamacare in the 2012 election and the court ruling. He agrees with Corbett that state taxpayers eventually could pay for an expanded program. Yet failing to expand Medicaid “could seal his fate” politically, DiSarro said.
Critics reacted to the few details made public about Corbett's plans.
“It's just an expansion of the welfare state,” said conservative Rep. Daryl Metcalfe, R-Cranberry. “It's still taxpayers' money, whether it's federal or state.”
Though the plan reportedly would expire if federal money dries up, “once you start a government program, good luck getting rid of it,” Metcalfe said.
Rep. Allyson Schwartz, a Democratic candidate for governor from Montgomery County, urged Corbett to simply agree to expand Medicaid on Jan. 1.
“For over a year, you have resisted calls from citizens across our state to take this opportunity to reduce our uninsured rate,” she said.
Corbett's spokeswoman, Lynn Lawson, said the governor “is committed to providing quality, accessible and affordable health care to Pennsylvanians.”
UPMC spokesman Paul Wood said the Corbett administration shared its proposals with the hospital giant, which administers Medicaid plans in Western Pennsylvania through its insurance division, UPMC Health Plan.
Though he would not address the plan specifics, Wood said, “UPMC applauds Gov. Corbett's efforts to find a way to ensure all Pennsylvanians have access to quality, affordable health insurance coverage.”
House Republicans were told the plan is an effort “to reduce the Medicaid rolls and rightly reform the benefit package, to make it sustainable and affordable,” said Stephen Miskin, spokesman for Majority Leader Mike Turzai, R-Bradford Woods.
Getting approval might “soften (Corbett's) image” as a budget-cutter, said Larry Ceisler, who owns a Philadelphia public relations firm. If Health and Human Services officials reject his ideas, “he can still say he tried on terms most favorable to Pennsylvania (taxpayers).”
J. Wesley Leckrone, a Widener University political science professor, said Corbett's plan might stand a chance.
“I really think the Obama administration wants as many people as possible (with insurance). Their legacy is on the line,” Leckrone said.
DiSarro thinks HHS approval is unlikely because it opens the door to unraveling deals for other states that accepted the department's terms.
Mary Beth Musumeci, a Medicaid expert at the nonpartisan Kaiser Family Foundation, said Arkansas and Iowa argued that alternatives would benefit poor people in several ways. People just below 138 percent of the federal poverty level could bounce in and out of the program if their incomes fluctuate. With private insurers, people would not have to worry about switching plans, Musumeci said.
“They believe it will promote continuity of care,” she said.
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