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Why Governor Corbett Is Right to Oppose Blanket Medicaid Expansion

April 10, 2013

Cost alone is reason enough for Governor Corbett to resist Washington’s call to swell the Medicaid rolls under the “Affordable Care Act” (ACA). Pennsylvania already trails only Missouri for Medicaid taking the largest bite out of its annual budget. Placing 800,000 more Pennsylvanians at a cost of $4 billion under Medicaid would leave even less money for public education, corrections, and other primary government responsibilities. Or, we do it and further buy into the inevitability of having to raise taxes.

But the Governor’s rationale goes beyond cost. It’s the same rationale that has him pushing for privatization of liquor sales and contracting state government to core functions. He believes in the private sector — not a trite sentiment in today’s political climate.

“Medicaid is very expensive for the taxpayers while delivering substandard care to recipients,” said PMA Executive Director David N. Taylor. “Governor Corbett and his team understand that, which is why they are continuing to press the Obama Administration for significant reforms to Medicaid, without which expansion would be ruinous for the Commonwealth.” 

That’s why the Governor’s questions in a meeting last week with HHS Secretary Kathleen Sebelius centered on prospective reforms to Pennsylvania’s Medicaid system: would HHS accept them?  Furthermore, rather than placing the additional 800,000 in Medicaid, could Pennsylvania direct them to the health insurance exchanges created under ACA?

Pennsylvania Medicaid benefits would be a platinum private plan. The benefits cover eight categories not required by the federal government. We provide an additional 29 optional services, also not required by Washington.  Some of these services include behavioral health rehabilitation services, chiropractic services, podiatrist services, and outpatient drug and alcohol clinic services. The Medicaid reforms the Governor wants would bring the benefits more in line with most private insurance plans. 

Directing those in need of coverage to the health insurance exchange, rather than Medicaid, mirrors a proposal in the Arkansas Legislature. The Arkansas measure would allow those who earn up to 138 percent of the poverty line, which amounts to $15,415 per year, to buy private insurance through the exchanges using federal Medicaid dollars.

Governor Corbett’s position regarding the ACA has never wavered. As Attorney General, he sued in an effort to strike-down the act. It’s now the law of the land, but he will not support Medicaid expansion without substantial changes because he worries about the long-term cost to Pennsylvania’s taxpayers.

“Until we know whether or not significant reform is possible, I continue to have concerns that Pennsylvania’s Medicaid program will be able to serve, in a sustainable manner, the approximately one in four Pennsylvanians that would be covered under a full expansion,” the Governor said after meeting Secretary Sebelius.