Corbett facing pressure from GOP on Medicaid

HARRISBURG - The pressure on Gov. Corbett to expand the state's Medicaid rolls is no longer only geographic; it's now coming from within his own party.

First there was Gov. Christie's announcement Tuesday that New Jersey would join other Pennsylvania neighbors - New York, Maryland, and Ohio - by opting in on the Medicaid expansion made available to all states under the Affordable Care Act.

Now the heat is coming from some of Corbett's fellow Republicans in the state legislature.

State Rep. Gene DiGirolamo (R., Bucks) said Wednesday that he supported Medicaid expansion because it would provide health insurance for an estimated 700,000 Pennsylvanians, many in low-wage jobs.

"We should do everything possible to get this done for the state of Pennsylvania," DiGirolamo, chairman of the Human Services Committee, said Wednesday. "Most of the people we are talking about are in the workforce making $10 to $12 an hour and have no health care."

At the same time, a top Senate Republican said he had tasked his staff with examining Medicaid expansion costs and benefits in advance of budget negotiations in the spring.

Appropriations Committee Chairman Jake Corman (R., Centre) said that the Senate GOP caucus might take a position of its own on Medicaid expansion - he did not elaborate - and that the issue could figure into the budget process.

"It's a hard thing to walk away from, but it's a hard thing to pay for," Corman said.

Corbett, in his Feb. 5 budget address, said, "At this time . . . I cannot support a dramatic Medicaid expansion" because of costs to the state down the road as the promised federal funding wanes and the state's burden grows.

Speaking to reporters Wednesday, Corbett said he planned to meet with U.S. Health and Human Services Secretary Kathleen Sebelius to discuss the issue but remained unconvinced he should follow other Republican governors such as Christie or Florida's Rick Scott - who last week reversed his stance and opted for Medicaid expansion - because each state has different health plans.

"Each state has to look at it as to what it means and what they already provide," Corbett said. "For instance, a lot of states don't have what we have here in Pennsylvania with our [Children's Health Insurance] program."

The Medicaid expansion option is politically complicated for Republican governors. On one hand, most (including Corbett) are on record as foes of the Democrat-backed health law known as Obamacare. On the other, as Christie noted Tuesday, cash-strapped states can hardly afford to turn away federal aid.

"I am no fan of the Affordable Care Act," Christie said, but turning down the federal money "just means [it] would be spent to expand health-care access" in other states.

For their part, federal health officials say they plan to stay in touch with the Corbett administration. "We have been happy to provide the governor and the state the answers to their questions, as well as the time and flexibility needed to make a decision on Medicaid expansion, and look forward to having a continued dialogue," an HHS official said on condition of anonymity.

Under the Affordable Care Act, the federal government will pay 100 percent of the added Medicaid cost for three years, beginning in 2014, and 90 percent in future years. That means as much as $4 billion a year in federal aid for Pennsylvania, according to federal and state estimates.

The Corbett administration estimates that by 2017, when the state would shoulder 10 percent of the expansion cost, Pennsylvania would pay as much as $1 billion a year.

DiGirolamo said that although he understood Corbett's concern, he - like Christie - believed it foolish to leave money on the table. He said the state winds up covering low-income residents' medical bills sooner or later.

"If we don't cover these folks, then they're going to show up at the emergency room and we will pay for that anyway," the Bucks lawmaker said. "That's the biggest selling point of this."

This article contains information from the Associated Press.