Corbett Aims for Special Deal on PA Medicaid Expansion

By Eric Boehm | PA Independent

HARRISBURG — Gov. Tom Corbett is continuing to seek a special deal with the federal government to increase flexibility in how Pennsylvania will administer Medicaid under the new federal health care law.

Corbett met Tuesday with federal Secretary of Health and Human Services Kathleen Sebelius, who is in charge of Medicaid, the health insurance program for the poor that is funded jointly by the states and the federal government.  On Wednesday, the governor described the meeting as productive but said it lacked any sort of definitive agreement between the two sides, though he acknowledged he wasn’t expecting one.

“There are ongoing discussions that will continue to flow back and forth,” Corbett said.

Corbett declined to go into the details of the negotiations, but earlier in the day on Wednesday his office put out a statement that implied Corbett was seeking a deal similar to what the federal government previously granted to Arkansas.

Under the provisions of that arrangement — struck by Democratic Gov. Mike Beebe — Arkansas would be able to use the private health insurance exchanges that are a part of the federal health care overhaul to cover Medicaid patients.

Under the provisions of the Affordable Care Act, states have the option to expand Medicaid with the federal government picking up the full cost for the first few years and a lower amount in subsequent years. Though most Republican governors initially opposed the expansion of Medicaid in their states many have since agreed to do so, Corbett remains one of the few holdouts.

Conservatives have encouraged Corbett to reject the Medicaid expansion, which would cost state taxpayers $2 billion over the next decade.

Even taking an Arkansas-style deal would be bad for the state because it would entrench the health exchanges and would rely on a cash-strapped federal government to keep its promises of funding most of the new costs from expanded Medicaid coverage, said Elizabeth Stelle, a policy analyst for the Commonwealth Foundation, a free market think tank in Harrisburg.

“The only acceptable reason to expand Medicaid would be full flexibility to customize Medicaid for all Pennsylvania residents,” Stelle said.

According to a recent report from the Congressional Budget Office, each patient enrolled in the health exchanges instead of Medicaid would add $3,000 in new costs.

But Democrats have said that Corbett would be foolish not to take the additional funding from the federal government to expand Medicaid.  They also point to the fact that about 800,000 residents will have new health coverage under Medicaid if Pennsylvania opts to expand the program.

Corbett on Wednesday reiterated that he would not be able to accept the Medicaid expansion until he had answers to all the questions he was asking of the federal government. As for a timetable for the decision, the governor acknowledged that he would like to have the issue settled before the budget deal in June.

Regardless of the outcome, Corbett said it was a shame the issue has become so politicized on both sides since he believes it should be more about the affordability and sustainability of Medicaid.

“That’s not political, it’s practical,” Corbett said. “And the dialogue on the political side distracts from that.”

Boehm can be reached at Eric@PAIndependent.com and follow @PAIndependent on Twitter for more.