It's enough to make your head spin. For congressional Republicans, it was enough to hold the federal government hostage for more than two weeks.
But when you cut through the political hype, the Affordable Care Act -- commonly known as Obamacare -- is really all about one thing: helping millions of Americans and hundreds of thousands of Pennsylvanians get access to affordable health care for themselves and their families.
One would think that our political leaders in Washington, regardless of their political party, would fight for those who need help. Yet the Tea Party Republicans in Congress and Tea Party governors throughout the country have done all they can to prevent millions of Americans from gaining health care coverage through this law.
Sadly, our own governor is among the zealots fighting against affordable health care through Obamacare.
After joining the failed lawsuit to block the law from taking effect, Gov. Tom Corbett is now effectively blocking more than a half-million working Pennsylvanians from getting covered through Medicaid expansion.
Medicaid expansion is the option under the new law for states to expand insurance to a larger group of working people with low incomes who don't qualify for Medicaid but also can't afford private insurance in the marketplace.
Gov. Corbett has refused to expand Medicaid in Pennsylvania, despite the fact that it would provide health care coverage for more than a half-million uninsured, working Pennsylvanians and despite the fact that it would bring an infusion of tens of billions of federal dollars into our state and local economies.
Under the Affordable Care Act, the federal government would cover 100 percent of the cost of Medicaid expansion for the first three years. Starting in 2017, the federal share would gradually drop to 90 percent, meaning states still would pay no more than 10 percent annually after the first three years.
Twenty-five states have accepted Medicaid expansion, including neighboring New York, New Jersey, Delaware, Maryland and West Virginia. But here in Pennsylvania, more than 500,000 uninsured, working Pennsylvanians will be left without coverage on Jan. 1.
Rather than expand Medicaid, Gov. Corbett has chosen a needlessly complicated -- and potentially more expensive -- approach that would send federal Medicaid dollars to private insurance carriers while adding unnecessary and likely illegal hurdles for Pennsylvanians to get coverage.
One of the most problematic and offensive pieces of the Corbett privatization plan is his insistence that Medicaid recipients search for work. Surely the governor is aware that, while many already work, 80 percent of Medicaid recipients are children, seniors or people with disabilities. Among the adults most likely to be impacted by this unnecessary requirement would be pregnant women and single mothers, many of whom already face significant barriers to employment.
Access to affordable health care is a critical need in our nation and our commonwealth -- according to a new analysis by the Hospital and Healthsystem Association of Pennsylvania, an all-time high of 15.9 percent of Pennsylvanians (some 1.3 million adults) are now without health insurance. We should be doing all we can to eliminate barriers to coverage.
Perhaps that's why no other state has proposed a work-search requirement and why the federal government prohibits states from imposing such unnecessary hurdles to health care coverage.
Gov. Corbett also proposes cutting benefits under Medicaid and imposing monthly premiums for recipients at 50 percent of the poverty level. Federal rules prohibit premiums below 150 percent of the poverty level.
With the federal poverty level for a single person at $11,490, Gov. Corbett's plan would force those making half that -- just $5,745 a year -- to pay a premium for their health care coverage. Gov. Corbett's plan adds a cruel and unnecessary financial burden on the poorest and most vulnerable Pennsylvanians.
Even if Gov. Corbett's plan receives federal approval, which is by no means guaranteed, it likely will take months of negotiations. That means that those Pennsylvanians who need Medicaid health care coverage will have to wait while their neighbors in other states start getting covered as of Jan. 1, using Pennsylvanians' federal tax dollars.
With zero cost to the state for the first three years, there's no reason to delay Medicaid expansion. Gov. Corbett can still negotiate with the federal government over his Medicaid privatization plan while hundreds of thousands of Pennsylvanians get the health care coverage they need.
It's important to understand who those uninsured Pennsylvanians are.
The vast majority of people who would receive coverage through Medicaid expansion are working men and women who either do not have health insurance provided by their employer or can't afford it. We're talking about restaurant workers, child care workers, cashiers, home health aides and many other hardworking Pennsylvanians.
They need health care coverage for themselves and their families. They cannot afford to wait.
Gov. Corbett should do the right thing for Pennsylvanians. He should end his partisan grudge against Obamacare and say "yes" to true Medicaid expansion.
State Rep. Frank Dermody of Oakmont is the Democratic leader of the Pennsylvania House of Representatives (www.pahouse.com/dermody). First Published October 19, 2013 8:00 PM