Expand Medicaid in Pennsylvania
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In his budget address last week, Gov. Tom Corbett called on Pennsylvania's leaders to be bold.
In the same speech, he recommended we refuse $37 billion of our citizens' federal tax dollars that could reduce the number of uninsured Pennsylvanians by half. He rejected the opportunity to use the power of publicly funded insurance to transform and improve the health care industry in our state. And he parted ways with other fiercely partisan Republican governors -- from states as diverse as Arizona, Ohio and Michigan -- who recognize that sometimes boldness means recognizing a transformative opportunity even if it comes from a Democratic president.
Gov. Corbett claims, paradoxically, that Pennsylvanians can't afford to receive some $37 billion over the next decade to expand Medicaid and enhance health care access in our state. Perhaps he considers this good politics at a time when far-right supporters believe that government shouldn't care for our most vulnerable residents. But it's bad policy -- for consumers, for health care providers and for our state finances, which would suffer much more from our refusing to extend health benefits than they would by our serving more people in need.
The federal government would pay 100 percent of up-front costs and 90 percent of long-term costs for all the Pennsylvanians newly eligible for Medicaid under the Affordable Care Act. Many are older adults who have not yet qualified for Medicare: people like veterans or older working adults whose children have grown up.
But what does the governor worry about?: that expanding Medicaid would make citizens who are already eligible realize they should have been getting coverage. These are people who live with a serious disability or care for a family with a below-poverty household income.
Gov. Corbett calls them people who may start coming out of the "woodwork." I call them people in need, to whom our state has made a promise.
And I have news for the governor: Those deserving citizens will probably sign up in spite of his decision. Starting later this year, all Americans will be reminded of the requirement to have health insurance under the Affordable Care Act. They also will have an easy way to find it, through a simple health insurance exchange that will tell them what their options are, how much their insurance will be subsidized and whether they're eligible for Medicaid.
Whether or not affordable insurance through Medicaid is offered to more Pennsylvanians, Medicaid is supposed to coordinate "seamlessly" with the health insurance exchange. So the "woodwork effect," as opponents call it, will be coming to Pennsylvania regardless. So will the costs to modernize our health insurance system. But the benefits offered to Pennsylvania will come only if we accept federal funding.
Gov. Corbett's other claim is that we shouldn't allow more money to flow into a system that doesn't work.
Everyone agrees that the fragmented care provided by our current system -- which too often drives people to the emergency room rather than the doctor's office -- needs attention. We also have too many people living with untreated mental illness because we've relied on a patchwork of public dollars to fill the gaps in an inadequate mental health care system. But this is why we should accept federal help -- to fix what's broken.
When the federal government offers money to update the technology for our safety-net services, we should accept it, be bold and modernize. When the federal government offers the opportunity to improve and expand our Medicaid program to provide better health care for the very poor, the disabled and the elderly, we should accept it, be bold and innovate. And when the federal government offers money to make sure that working Pennsylvanians can access primary care services so they don't have to rely so heavily on expensive emergency room visits, we should accept it, say thank you and put it to work.
Yes, the governor is right about the need to bring down health care costs in Pennsylvania -- in both the government and private sectors. But when more people have access to health insurance, our commonwealth and private insurers will have more power to require that our health care system provide better health care more efficiently. Only when we bring nearly everyone into the system can we truly reform it.
We should, indeed, be bold.
First Published February 11, 2013 12:00 am
