DN Editorial: Corbett's health-care compromise is somewhat healthier

AN AGREEMENT reached last week between the federal government and Gov. Corbett on an expanded Medicaid program means that Pennsylvania will join the ranks of states whose poorer citizens aren't doomed to a short and/or sick life because they can't afford health care.

When the federal government offered Medicaid expansion to states as part of the Affordable Care Act, the majority of Republican governors rejected that offer, claiming it would be too expensive to expand eligibility, despite the fact that the feds would pick up almost all of the tab: 100 percent in the first year, and 90 percent thereafter.

This collective hissy fit contributed to the creation of a new division in an increasingly polarized country: those with health coverage, and those without. But more importantly, the holdout states led to the shameful situation whereby millions were left without any coverage.

In Pennsylvania alone, while Corbett was constructing his counterproposal to the feds in the last year, about 500,000 people were left ineligible for any coverage.

Corbett's "Healthy PA" plan will provide coverage for those unable to qualify for either federal subsidies in the health exchange or traditional Medicaid. It will require the state to essentially build a new managed-care system to administer the program, which has some worried that it will be inefficient and cumbersome. "Healthy PA" also will require many to pay premiums - though those won't kick in until January 2016.

But the feds did reject a Corbett proposal to require a job search, as well as the need for people to take "responsibility" for their own health. The Corbett administration will instead create a program that will provide incentives for work search or training, and those participating may see a reduction in their health-care costs.

We're still bothered by the underlying assumption of the Corbett administration linking health coverage to proof of a job search - that Medicaid is a welfare system that encourages the lazy to skip the search for work and live off the government. This signals a massive lack of awareness of the realities of Medicaid recipients and of the marketplace.

According to Community Legal Services, three-fifths of all adults who make up the Medicaid expansion population are either working or are members of working households. Most Medicaid recipients who are able to work do work, or are looking for work. The reality is, jobs are not plentiful, and too many that are available don't pay enough to sustain the basic necessities, let alone provide the Cadillac health plans to which most elected officials are entitled.

There is further concern that under "Healthy PA" specific benefits will come with new limits. For example, new annual limits have been imposed on certain categories of treatments, like radiology, medical supplies and drug and alcohol treatment. For those who need that coverage, and that includes people with and without disabilities, this seems like a sickening turn of events.

But the bottom line of the feds' approval of Corbett's plan is, overall, positive. People who have no health coverage now will have options. And rather than rejecting expansion outright, as all but nine Republican governors have done, Corbett has found a workable compromise with the feds. In the process, he has accepted the responsibility for ensuring that being poor does not necessarily mean a grim prognosis for the future.