Expand Medicaid temporarily while awaiting a decision on Corbett's Healthy PA plan
Bringing more federal money into the state will help the uninsured, the state budget and the Pennsylvania economy
June 30, 2014 12:00 AM
By JENNIFER CLARKE and LAURA R. SMITH
Gov. Tom Corbett has a rare opportunity to score a win-win for Pennsylvania. A bill introduced by Republican Rep. Gene DiGirolamo of Bucks County would simultaneously help close the state’s budget gap and make health insurance available to more than 500,000 lower-income Pennsylvanians.
Approved this month by a bipartisan majority of the House Human Services Committee, the bill would temporarily expand traditional Medicaid under the Affordable Care Act — which would be paid for entirely by the federal government — while the governor awaits word on whether his Healthy Pennsylvania Medicaid reform plan is approved by federal officials.
Twice in the last few weeks, Gov. Corbett has recognized when sensible policy and the will of Pennsylvanians intersect and has made responsible decisions even though they cut against perceived party lines or his own personal views.
Last month, the governor declined to appeal a judge’s ruling that prohibited enforcement of Pennsylvania’s controversial voter ID law, which would have disenfranchised hundreds of thousands of Pennsylvanians. Two weeks later, he opted not to challenge a federal judge’s ruling that it is unconstitutional to ban same-sex marriage. While the decision went against the governor’s personal beliefs about marriage, most Pennsylvanians support same-sex marriage and Mr. Corbett recognized that the chances of winning on appeal were slim.
This ability to recognize changing realities and the will of the citizenry is a valuable trait for any elected leader — a trait Gov. Corbett has the chance to exhibit for a third time now.
The Affordable Care Act gives states the option to use federal funds to extend Medicaid coverage to certain uninsured people, many of whom are low-wage workers who cannot obtain insurance through their jobs, cannot afford to purchase private insurance and do not qualify for the existing state Medicaid program. Every state bordering Pennsylvania has accepted these funds. Last year, the Republican-led state Senate passed a bill that would have expanded Medicaid in Pennsylvania, but House Republicans later stripped Medicaid expansion from the bill.
In February, Gov. Corbett asked the federal government to approve his Healthy Pennsylvania plan, which would expand Medicaid eligibility but roll back many Medicaid benefits for both new and existing enrollees. We joined a wide range of advocates in calling on the federal government to reject the plan unless it is amended to restore these benefits.
Even if the federal government approves the plan in some form, it would not take effect until January at the earliest. While the federal government continues its lengthy review of Healthy Pennsylvania, Rep. DiGirolamo’s bill would provide health insurance, at least temporarily, to hundreds of thousands of Pennsylvanians who now are uninsured and unable to access health care.
This bill would not only make Pennsylvania healthier, it also would help balance the state’s budget. Because of Gov. Corbett’s decision not to expand Medicaid, Pennsylvania is missing out on an estimated $5 million to $10 million in federal funds with each passing day. But if this bill becomes law, the federal government would pay 100 percent of the cost of insuring all newly eligible Medicaid enrollees until the end of 2016, when the temporary bridge coverage in Rep. DiGirolamo’s bill is set to expire.
The bill explicitly protects the state against unforeseen financial risk; the state could end the expanded coverage if, at any time, the federal government fails to pay 100 percent of the costs of insuring newly eligible Medicaid enrollees.
Expanding Medicaid now would generate real and immediate economic benefits for Pennsylvania. So far this year, General Fund tax revenue collections are far lower than budgeted. According to the nonpartisan Pennsylvania Budget and Policy Center, the state’s revenue deficit had reached $613 million as of June 4, still a few weeks shy of the close of the fiscal year.
Implementing Medicaid expansion now would help solve this serious budget shortfall. In May 2013, Pennsylvania’s Independent Fiscal Office found that Medicaid expansion would save the state $620 million in the 2014-2015 budget by having the federal government pick up costs now covered by state Medical Assistance funds. It also would produce new tax revenue from hundreds of millions of new federal dollars flowing into the state.
In addition, the RAND Corp. found last year that Medicaid expansion would create about 35,000 new jobs in Pennsylvania, where unemployment still lagged at 5.6 percent last month. Pennsylvanians recognize these benefits: An April poll conducted by Public Policy Polling found that 59 percent of Pennsylvania voters supported expanding Medicaid.
Rep. DiGirolamo’s bill is sensible legislation with bipartisan support and enormous health and economic benefits. It is good policy, fiscally responsible and would make Pennsylvania a more fair and healthy place to call home.
Jennifer Clarke is executive director and Laura R. Smith is an intern at the Public Interest Law Center of Philadelphia.
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