Doctors: Expand Medicaid

He had a meeting, but he still doesn’t have a decision.

Gov. Tom Corbett says he still has questions about a possible expansion of the Medicaid program in Pennsylvania, despite a Tuesday meeting with U.S. Department of Health and Human Services Secretary Kathleen Sebelius.

Corbett had requested the meeting to clear up remaining questions on the possible expansion before making a decision on whether Pennsylvania would participate.

Meanwhile, health care professionals in Warren County are urging the governor to go along with the expansion.

In February, Corbett indicated he wanted further information from Health and Human Services (HHS) before agreeing to an expansion.

At the time, Corbett rejected the expansion in February, saying, “At this time, without serious reforms, it would be financially unsustainable for Pennsylvania taxpayers, and I cannot recommend a dramatic Medicaid expansion.”

Federal funding would cover 100 percent of expanded costs from implementation in 2014 through 2016 and continue to cover at least 90 percent of costs thereafter.

“Until we know whether or not significant reform is possible, I continue to have concerns that Pennsylvania’s Medicaid program will be able to serve, in a sustainable manner, the approximately one in four Pennsylvanians that would be covered under a full expansion,” Corbett said in a Wednesday press release.

The expansion would extend Medicaid coverage to all adults with income up to 133 percent of the federal poverty line, rather than just select populations.

The Kaiser Commission on Medicaid and the Uninsured estimates that 542,000 Pennsylvanians would be newly eligible for Medicaid under an expansion and that an additional 178,000 currently eligible residents may enroll after the implementation of insurance exchanges, another component of the Affordable Care Act.

The estimated additions would mean approximately three million Pennsylvanians, or about one in four, would receive coverage under the state’s Medicaid program.

Corbett is facing mounting pressure to agree to an expansion from groups within the healthcare community.

A February report from Families USA and the Pennsylvania Health Access Network estimate an expansion would create more than 40,000 jobs and $5.1 billion in increased economic activity.

Meanwhile, the Hospital and Health Association of Pennsylvania sponsored a report by Rand Corp. which indicated the expansion would extend coverage to up to 350,000 low-income Pennsylvanians, provide approximately $3.2 billion in annual economic growth and lead to between 35,000 and 39,000 jobs.

An expansion of coverage to 350,000 new patients would reduce the uninsured rate in the state from 12.7 percent to 4.8 percent by 2016, according to the Rand report.

The expansion is backed by healthcare professionals in Warren County.

“If Gov. Corbett does not expand the Medicaid plan in Pennsylvania, Warren General Hospital (WGH) will be directly impacted,” said Warren General Hospital CEO John Papalia. “The effects of Gov. Corbett’s decision will raise the already high percentage of annual charity care provided by Warren General Hospital. In FY (fiscal year) 2012, the charity care was in excess of $5.8 million. By not approving the Medicaid expansion, this number will only grow in the coming years.

“WGH will continue to treat patients that cannot afford health care. The Medicaid expansion, if implemented in Pennsylvania, would provide many patients with the coverage they desperately need. Patients would be able to have annual routine physician appointments and preventative screenings. It will allow patients to be proactive about their health.”

Dr. David McConnell of Warren Pediatric Associates also cited the benefits of an expansion.

“Approximately 35 percent of the patients seen at Warren Pediatrics are Medicaid patients,” McConnell said. “If the expansion is approved, a large portion of the local population will benefit from this funding. Many families currently fall into a gap that their income is too high to apply for Medicaid eligibility, but they make too little to afford private insurance. The expansion will remedy this issue for many families, making them eligible for Medicaid.”

The American Association of Retired Persons (AARP) also endorses an expansion.

Corbett indicated interest Wednesday in a system which would allow usage of federal Medicaid dollars to purchase private insurance coverage for residents covered under an expansion through the insurance exchanges set to be implemented.

The Congressional Budget Office reported last summer that private insurance plans are more expensive for taxpayers than traditional Medicaid coverage. The report estimated purchasing a private plan through the insurance exchanges would cost approximately $9,000, while traditional Medicaid coverage would cost approximately $6,000.

Governors in Arkansas, Missouri and Ohio are exploring similar plans to use public funding to buy private insurance for individuals newly eligible under an expansion.

While the expansion is a part of the Affordable Care Act, known as Obamacare, the U.S. Supreme Court ruled states could not be required to broaden Medicaid programs. While he was still Pennsylvania’s attorney general, Corbett unsuccessfully sued to overturn the Affordable Care Act.

According to the Wednesday press release, “Corbett indicated that he will await further information from HHS and that no further decisions will be made at this time.”