Monday, October 20, 2014
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How Medicaid expansion could solve Pennsylvania's budget crisis

State lawmakers have less than two weeks to close a projected $1.2 billion budget shortfall. As the Inquirer recently reported, tax collections in the current fiscal year are $600 million behind projections. That leaves lawmakers with a choice that no elected official wants to make in an election year: raise taxes, or further cut into vital services that have already taken substantial hits in previous years.

How Medicaid expansion could solve Pennsylvania’s budget crisis

PA Independent photo

State lawmakers have less than two weeks to close a projected $1.2 billion budget shortfall. As the Inquirer recently reported, tax collections in the current fiscal year are $600 million behind projections. That leaves lawmakers with a choice that no elected official wants to make in an election year: raise taxes, or further cut into vital services that have already taken substantial hits in previous years.

But there’s another choice. A simple, obvious, straightforward solution – one that’s not only fiscally responsible, but also supported by sixty percent of Pennsylvania voters: Medicaid Expansion; specifically, a temporary expansion of health coverage as a bridge until a decision on the Governor’s “Healthy PA” plan is made.

Lawmakers in New Hampshire recently pursued this option, in response to a persistent public outcry over the legislature blocking access to health care for low-income residents, and the fiscal realities facing their state. Recently, the Republican-controlled Senate came together with the Democratic-controlled House to enact a Medicaid pilot project, expanding coverage and drawing down federal funds while they await a decision on their state’s private option waiver request.

Like Pennsylvania, New Hampshire preferred an expansion of coverage that utilized private carriers, rather than traditional Medicaid, and submitted a waiver request to the federal government to move forward with a modified expansion. However, New Hampshire lawmakers realized that blocking access to coverage and rejecting federal funding in the interim – funding that could be working to create jobs, protect the fiscal health of rural and community hospitals and save taxpayer money – was damaging to the state’s economy and health of its low-income families.

We could absolutely do that here in Pennsylvania, and we absolutely need to do that, right away.

Since January 1st, Pennsylvania has blocked $4.8 million dollars in federal funding to expand coverage from coming into our state’s economy. That’s money that could be strengthening rural and community hospitals, creating jobs, and stimulating billions in new economic activity across the Commonwealth.

Accepting federal funding now to expand health care coverage as a temporary bridge to Healthy PA would secure $600 million for Pennsylvania’s 2014 – 2015 budget, a combination of savings and new revenue affirmed by three separate economic analyses, including one by Pennsylvania's Independent Fiscal Office.

Saying yes to a temporary “bridge” expansion would ensure that negotiations over Healthy PA continue, without leaving hundreds of millions of dollars in federal funding on the table that could help Pennsylvania’s economy right now. We’ve got a coverage gap, and a budget gap, and we can begin to close them both by expanding Medicaid.

Antoinette Kraus Director of the Pennsylvania Health Access Network
About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on Inquirer.com and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Donald Schwarz, MD, MPH Deputy Mayor for Health & Opportunity and Health Commissioner for the City of Philadelphia
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
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