Gov. Corbett, meet Joanne Davis.
With some savings, she's not poor enough for Medicaid. At age 53, she's not old enough for Medicare. Davis, working a part-time temp job for $8 an hour, falls in that perilous chasm in between.
"God forbid I get sick," she told me. "It will wipe out everything."
However, she does qualify for the Medicaid expansion under the Affordable Care Act, in which the federal government would pay 100 percent for three years, then nothing less than 90 percent. She would receive coverage if she lived in neighboring New Jersey, New York, Ohio, or Maryland.
But Davis has a problem. She lives in Pennsylvania.
Gov. Corbett called the Medicaid expansion "financially unsustainable for the taxpayers." He rejected coverage, for now, and an estimated $17 billion in federal aid during the next six years for Davis and almost 700,000 other Pennsylvanians. Many of these residents are middle-aged, in low-wage jobs, and without dependent children yet are facing growing health issues.
Corbett said last week that his administration "sent out repeated questions to the U.S. Department of Health and Human Services and Secretary [Kathleen] Sebelius that have not been satisfactorily answered or answered at all." Until he receives sufficient responses about costs, Corbett says he will not accept Medicaid funding.
Pennsylvania is virtually surrounded by states accepting expansion, including some governed by fellow Republicans, and Corbett's decision has drawn criticism from members of his own party over declining billions in federal money even as they struggle with the state budget. Hospitals and doctors, which would benefit from the expansion, are also pressuring the governor.
Following the rules
For much of her life, Davis did everything right. She moved out of public housing, off assistance, took classes at night. For 17 years, the Philadelphia resident worked in customer service for a large medical-device company. Davis earned a $38,000 salary and put a chunk of money away in a 401(k).
She bought a house, a car, and still has insurance coverage for both of them. Just not for herself.
"My car is more valuable than I am," Davis said sitting in her tidy, spare Overbrook Park rowhouse. "If I get in a car accident, I'm covered. Otherwise, if I just break a bone, break a leg, I could lose my home. I'd be done."
Until she lost her job and Blue Cross insurance five years ago, Davis received annual mammograms and cholesterol screenings. She worked out, tried to take care of herself. "I'm very interested in preventive health." Her mother died of breast cancer at 65, her father from cardiovascular disease at 70.
The best job she's been able to land is as a receptionist working 20 hours a week for a tax preparer that will end in April. Just as she scours classifieds for job openings, and attends job fairs, Davis also looks for free or low-cost health services. She has osteoarthritis but can't afford prescription pain relief, depending instead on Aleve.
Her savings have dwindled to $23,000, and draw down $4,000 every four months for bills. For her birthday, she asked for eyeglasses and groceries.
"I've been working since I was 14. I've paid a lot into the system," she said, referring to state and federal taxes that help fund Medicaid and will support people like her in other states. "We shouldn't be living like Third World citizens in a wealthy country."
If she had the chance to speak with Corbett, Davis would tell him: "You can't just use statistics. There are women ages 46 to 62, who don't have young children, who are devastated by this economy and facing the most serious health issues of our life."
At 53, she most likely won't qualify for Medicare for a dozen years. "That is a long time, a very long time, to go without seeing a doctor."
Contact Karen Heller
at firstname.lastname@example.org or 215-854-2586, or follow on Twitter at @kheller.