HARRISBURG -- On the eve of the deadline for state governments to tell Washington whether they intend to run their own health insurance exchanges, federal officials announced a one-month extension for Pennsylvania and other undecided states to make up their minds.
Earlier Thursday, Gov. Tom Corbett's administration offered no clues as to whether it prefers a state-run clearinghouse for residents to compare and purchase health insurance, or one that is either partly or fully run through the U.S. Department of Health and Human Services.
The state insurance department again noted that federal officials haven't responded to questions that it posed in August about various aspects of creating the insurance exchange required to be in place by January 2014.
"I'm looking at the cost to Pennsylvania taxpayers and whether we can afford it," said Mr. Corbett -- who as attorney general signed on to the lawsuit against the health care law -- last Friday.
Pennsylvania officials now must say by Dec. 14 if they plan to run the state's insurance marketplace and send in a detailed blueprint for creating it. If they opt instead to partner with the federal government on running Pennsylvania's insurance exchange, they still have until Feb. 15 to announce that decision.
The commonwealth has been awarded nearly $35 million in planning grants for creating its insurance exchange.
According to Katharine Witgert of the National Academy for State Health Policy, data available Thursday showed 15 states have chosen to run their own exchanges, another 15 are opting for federally run programs, and four are requesting the partnership option.
Additional decisions also are looming for Pennsylvania related to the 2010 federal health care law, including an option to expand its Medicaid eligibility rules.
While the federal government will cover 100 percent for the additional Medicaid costs through 2016 and 90 percent thereafter, states still need to project how many residents may enroll and related economic impact, Ms. Witgert said during a budget outlook presentation Thursday.
A Kaiser Family Foundation study estimated that Pennsylvania should expect between 482,000 and 683,000 more Medicaid recipients if it expands access, at a cost to the state of $1.1 billion to $2 billion. Federal officials would provide between $17 billion and $20 billion over six years.
But that decision comes as Pennsylvania likely will be budgeting for yet another year for slow economic growth. Staffers with the Independent Fiscal Office released a new outlook report Thursday forecasting a paltry 0.8 percent in economic growth for the 2013-14 fiscal year, while state pension costs are set to increase by $500 million.
The fiscal office did not include a potential expansion of Pennsylvania's Medicaid rolls in its new report.
Harrisburg Bureau Chief Laura Olson: email@example.com or 717-787-4254.