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Corbett seeks approval for Medicaid alternative

| Thursday, Dec. 5, 2013, 8:42 p.m.
Stephanie Strasburg | Tribune-Review
The governor skipped the state GOP’s fall dinner on Friday to take in a Pirates game, a move political observers said could pay off at election time more than dining with the party faithful would. Republican Gov. Tom Corbett, who faces a potentially tough re-election race next year, was at the game in PNC Park when the Bucs lost 6-5 to the Cincinnati Reds in their battle for a playoff spot.

HARRISBURG — Gov. Tom Corbett will begin the formal process on Friday of seeking approval for his plan to bring billions of federal Medicaid expansion dollars to Pennsylvania to extend health insurance to half a million working poor.

The process will begin with the online posting of Corbett's approximately 100-page proposal, which lays out more detail surrounding his plan to use the expansion money to help people buy private insurance, rather than cover them under the traditional Medicaid program.

The administration also will announce six hearings on the plan around Pennsylvania — in Philadelphia, Pittsburgh, Altoona, Harrisburg, Erie and Scranton — plus two online seminars and a public comment period lasting through Jan. 13 before submitting the proposal to the federal government, possibly in February.

A key element of Corbett's proposal will be the contention that buying private insurance will cost the federal government the same amount of money, or less, than an expansion of Medicaid, which tends to be cheaper because it typically pays doctors and hospitals less for care than does private insurance.

The federal government requires such cost neutrality before it allows a state to make certain changes to its Medicaid program, Corbett administration officials say.

Under President Obama's signature health care law, the federal government promises to foot the lion's share of the bill for any state that broadens its Medicaid eligibility guidelines to cover more low-income adults. The Medi-caid expansion is a key element of the law's goal of providing health insurance to tens of millions more Americans.

However, Corbett is a critic of Medicaid and an opponent of the law, and instead wants to use the expansion money for private insurance plans, an idea the federal government approved in Arkansas.

The federal Medicaid expansion dollars become available Jan. 1. There is heavy in-state pressure on Corbett to embrace a Medicaid expansion from groups including the AARP, labor unions, advocates for the poor, hospital and doctors' groups and even the Republican-controlled state Senate.

Corbett is packaging his Medicaid proposal with a number of conditions that he says make it a better and more affordable way of providing health insurance. But it is not yet clear whether the Obama administration will agree to Corbett's conditions, or how long past Jan. 1 it will take to come to an agreement.

Twenty-five states and Washington now plan a Medicaid expansion of one sort or another, including some states run by Corbett's fellow Republican governors and every state that neighbors Pennsylvania. Seven states, including Pennsylvania, are considering it.

Under Corbett's proposal, many adults with incomes of up to 138 percent of the federal poverty level, or about $32,000 annually for a family of four, would become newly eligible for a private insurance plan that would be paid for by Medicaid dollars. The plans would be sold through the health insurance exchange that was created as part of the law with the goal of helping people and small business owners afford a comprehensive insurance plan.

Corbett wants to pare back benefits for able-bodied adults who are already on Medicaid, eliminate co-pays in favor of a new premium structure and require the unemployed and able-bodied who are working 20 hours or less to meet certain work-search goals, including engaging in 12 job-searching activities each month.

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