As a Republican, Jamie Coleman might be expected to side with Pennsylvania Gov. Corbett when he wrote that an expansion of federal Medicaid - health coverage for the poor - would be a bad idea for state taxpayers.
But as a nurse at the Hershey Medical Center, she has a different point of view:
"There will be some impact," Coleman said. "What that means we don't know yet. We're not sure if it is going to cause layoffs, or if there will be some facilities in the state closing down."
To Coleman, it's a health issue and an economic issue.
A report Thursday from Families USA and the Pennsylvania Health Access Network said expanding Medicaid would lead to 41,200 new jobs in 2016, as $3.5 billion more in Medicaid funding would flow into the state to cover as many as 682,000 uninsured low-income Pennsylvanians.
Another report, from Moody's Analytics, an economic-forecasting firm in West Chester, disagreed, saying the job impact would be minimal.
If Pennsylvania didn't accept the expanded Medicaid money, 11,000 jobs would not be added in the next decade, Moody's reported.
"It's very, very small, statistically insignificant, almost a rounding error," economist Daniel White wrote in January.
Families USA, favoring expansion, plans to report on New Jersey's situation on Feb. 28.
Whether Medicaid expansion would add or decrease jobs is key in the Philadelphia area, which relies heavily on health-care employment.
The estimated $3.5 billion increase, payable primarily to doctors and hospitals in Pennsylvania, would generate an additional $1.6 billion in indirect spending to medical suppliers, the Families USA report said.
Unanswered, White said, is whether Medicaid money would then be unavailable for other job-generating programs.
The U.S. Supreme Court decision in July upheld most of the Affordable Care Act. But the justices gave states leeway to decide whether they wanted to join an expansion of Medicaid.
Hospitals, doctors, advocacy groups, and labor unions are pushing Corbett and the legislature to reconsider turning away Medicaid money.
New Jersey's Gov. Christie is undecided.
But some Republican governors, even those who oppose the Affordable Care Act, have decided to accept the money - among them Florida Gov. Rick Scott, who announced his change of heart on Wednesday.
The Medicaid expansion came with a sweet incentive. The federal government would pay 100 percent of the expanded costs initially and 90 percent thereafter, starting in 2020.
Neal Bisno, Pennsylvania health-care director for the Service Employees International Union, which represents 25,000 health-care workers in the state, is pushing for the expansion.
"In so many communities, health-care institutions are the largest employers," he said. "Pennsylvania is literally denying good-quality jobs to tens of thousands of Pennsylvanians - good jobs providing vital care to people in need."
Curt Schroder, regional executive of the Delaware Valley Healthcare Council of the Hospital and Healthsystem Association of Pennsylvania, is also lobbying for the expansion.
The Affordable Care Act, he said, still includes funding cuts for charitable care. The act assumed Medicaid expansion would cover more people, who would need less free care.
In Pennsylvania, he said, cuts for charitable care amount to $1.9 billion over the next decade.
Contact Jane M. Von Bergen