Corbett should stand up for state and take Medicaid expansion

Posted: July 12, 2012

TEXAS GOV. RICK Perry this week became the latest Republican governor to refuse an extension of Medicaid that would allow his state to provide decent health-care coverage to millions more of its poorest citizens — with the federal government picking up most of the bill for the next several years.

Perry joined governors from Wisconsin, Louisiana, Mississippi, South Carolina and Florida — most of them states with a high percentage of uninsured citizens — in a chorus of "Take your Medicaid Extension and Shove It." Other Republican governors, including New Jersey's Chris Christie, have indicated they might follow.

So far, Gov. Corbett has been quiet about whether he would pass up the chance to provide coverage to an estimated 685,000 more Pennsylvanians from 2014 to 2019.

We hope Corbett's silence is due to a recognition that — even when the commonwealth has to pick up a small percentage of the costs — Medicaid expansion will save money not only for hospitals but also for taxpayers. We hope Corbett has not joined the "me-toos" because he understands that the issue is too important for political posturing, even in a presidential election year.

A major way that the 2010 health-care-reform law, a/k/a Obamacare, increases health insurance coverage is by expanding Medicaid eligibility to people with incomes below 133 percent of the federal poverty guidelines (about $15,000 for an individual and about $30,600 for a family of four.) From 2014 to 2017, the feds would pick up 100 percent of the tab for the expansion, then decrease their share to 90 percent by 2020.

Last month, while upholding the core of the ACA, the U.S. Supreme Court allowed states to opt out of the expansion and not lose the federal funds they now get for Medicaid — at the same time providing an easy way for Republican governors to grab headlines while bashing President Obama before the November election.

Afterwards, it's not so clear: Some observers believe that a few vocal refuseniks will eventually change their tunes. Not surprisingly, the stingiest "red" states, the ones that now provide Medicaid coverage to the fewest citizens, stand to gain the most from expansion. (Pennsylvania, by the way, is among the 10 states that will benefit least. Which state takes the prize? Why Massachusetts, of course, where most citizens have decent health insurance, courtesy of a law championed by former Gov. Mitt Romney.)

There is sure to be intense lobbying for Medicaid expansion by hospitals that get stuck with much of the bill when uninsured people show up at emergency rooms for care that they are obligated by law to provide. A large number of those patients are suffering from medical problems that could have been dealt with much earlier (and more cheaply) if only they had been able to afford to go to a doctor.

Besides, Medicaid already covers 65 percent of elderly nursing-home residents in Pennsylvania, no doubt saving many of their relatives from financial ruin.

So when Corbett finally announces his decision on Medicaid expansion, he should show Pennsylvanians that he recognizes a good deal when he sees one — and will take it.

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