Pa. Senate prepares for Medicaid vote

GOP setting conditions for expansion in state under federal law

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HARRISBURG -- Senate Republicans are working toward a vote next week on a measure that, upon certain conditions, would expand Medicaid eligibility in Pennsylvania under the federal health care law.

Such a proposal faces a more difficult path in the House, where a spokesman for the Republican majority said there are no plans to bring Medicaid expansion to a vote.

But a spokesman for Gov. Tom Corbett said it appeared the Senate Republicans are considering changes to the Medicaid program similar to those the administration has requested during talks with the U.S. Department of Health and Human Services. Mr. Corbett has said for months that he will not agree to expand Medicaid eligibility unless the federal government allows Pennsylvania to make changes to its program. His staff has given examples such as allowing the state to require job training or copayments from recipients.

Senate President Pro Tem Joe Scarnati, R-Jefferson, said in an interview Friday that Senate Republicans have been working for some time on a plan to expand eligibility for Medicaid health coverage, provided that certain conditions are met.

Those conditions have not been finalized, he said, but he gave the example of requiring the continuation of coverage under the state Children's Health Insurance Program. Corbett administration officials have said some children covered under the CHIP program could be moved by the law into Medicaid.

"It's going to be a Republican-formulated plan," Mr. Scarnati said. "Just straight Medicaid expansion doesn't entice us. But if we're able to do it with conditions, then that's something we're willing to look at."

"We have the responsibility to govern," he said. "Whether we like it or not, this is something before us, and we need to take a serious look at it with our budget."

Senate Republicans are having conversations aimed at reaching a proposal that most or all of the caucus can support, said Erik Arneson, a spokesman for Senate Majority Leader Dominic Pileggi, R-Delaware.

He said Mr. Pileggi expects a vote of some kind next week.

Corbett administration officials describe their conversations with federal officials over Medicaid expansion as starting on their side with requests to change the state's existing program.

Kevin Harley, the governor's press secretary, said the Senate proposal may be consistent with that position.

"It's my understanding from what the Senate is discussing that they are also talking about reforming Medicaid," he said. "I think we share the goal of reforming Medicaid and making sure it is sustainable for the taxpayers."

Democrats in the General Assembly have demanded that Pennsylvania agree to expand Medicaid eligibility, a component of the federal health care law made optional by a ruling of the U.S. Supreme Court.

"This issue has been driven by the Senate Democrats," said Minority Leader Jay Costa, D-Forest Hills. "We've been the ones who have been talking consistently about doing Medicaid expansion. We've been gaining support as we've gone along."

He said he expects a proposal to pass the Senate with support from Republicans and Democrats.

Sen. Vince Hughes of Philadelphia, the ranking Democrat on the Appropriations Committee, said he hopes conversations over the weekend will lead to an agreement by Monday. He noted that Democrats do not believe additional conditions are needed.

"We want to hear in greater detail what the Senate Republicans have to say," Mr. Hughes said. "We get concerned when folks start talking about work requirements, when folks talk about copayments, things of that nature. We get very concerned about that."

In the House, Steve Miskin, a spokesman for Republicans, said Pennsylvania cannot sustain its current level of Medicaid spending, much less expanded coverage.

"As of right now, there are absolutely no plans whatsoever to bring a Medicaid expansion bill or anything containing that to the House floor for a vote," he said. "Without making serious reforms and changes, without getting guidance from the federal government, we think it's absolutely ill-advised to even consider an expansion."

After a hearing Thursday on the issue, Rep. Matt Baker, R-Tioga and chairman of the House Health Committee, wrote to Republican House members that he believes Medicaid expansion is wrong for the state.

state - health

Karen Langley: klangley@post-gazette.com or 1-717-787-2141.


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