Pa. Med­i­caid ex­pan­sion is a mixed bless­ing

The Times Herald (Norristown, PA) - - OPINION -

For­give us if we’re not jumping for joy at the news that the U.S. Depart­ment of Health and Hu­man Ser­vices last week granted Gov. Tom Cor­bett a Med­i­caid waiver, bring­ing him a step closer to the im­ple­men­ta­tion of his “Healthy PA” pro­gram.

His sup­port­ers in the business and physi­cian com­mu­nity claim that when and if it is im­ple­mented next year, it will even­tu­ally give as many as 600,000 low­in­come Penn­syl­va­ni­ans ac­cess to af­ford­able health care un­der the new Oba­macare law.

The waiver comes more than seven months after Cor­bett re­jected an es­ti­mated $3.3 bil­lion in fed­eral Med­i­caid ex­pan­sion funds that would have al­lowed those same work­ing Penn­syl­va­ni­ans to have had af­ford­able health care cov­er­age all of this time.

The Med­i­caid ex­pan­sion funds have been made avail­able to all states to cover work­ing Americans who earn too much to qual­ify for tra­di­tional Med­i­cal As­sis­tance but not enough to buy into the Af­ford­able Care Act’s Health In­surance Mar­ket­place which was de­signed to pro­vide com­pet­i­tively-priced health plans for unin­sured or un­der­in­sured Americans.

Cor­bett’s main con­cern was that the promised fed­eral money would even­tu­ally dis­ap­pear just like the “stim­u­lus” money did a few years ago, leav­ing Penn­syl­va­nia tax­pay­ers stuck with the enor­mous cost of pay­ing for the Med­i­caid ex­pan­sion.

Cor­bett’s re­fusal to ac­cept the Med­i­caid ex­pan­sion funds in Jan­uary has caused some of the 318,000 Penn­syl­va­nia res­i­dents cur­rently en­rolled in Oba­macare to fall into the health care gap when the gov­er­nor al­lowed Penn­syl­va­nia’s rel­a­tively low­cost adultBa­sic in­surance pro­gram to ex­pire. His so­lu­tion was to di­rect those peo­ple to a Blue Cross pro­gram with pre­mi­ums as much as 400 per­cent higher and fewer ser­vices than adultBa­sic. More than 1,700 Delaware County res­i­dents re­lied on adultBa­sic and more than 17,400 Delaware County res­i­dents were on the wait­ing list for the low­in­come in­surance.

Cor­bett’s ver­sion of Med­i­caid cov­er­age, dubbed Healthy PA, will still not be af­ford­able to many low-in­come work­ing fam­i­lies and will limit ac­cess to crit­i­cal health ser­vices, ac­cord­ing to Sharon Ward, di­rec­tor of the Penn­syl­va­nia Bud­get and Pol­icy Cen­ter. Be­cause it dif­fers from the cur­rent Med­i­caid sys­tem and the Health In­surance Mar­ket­place, Healthy PA will also es­tab­lish ad­di­tional bu­reau­cratic red tape.

Be­fore Cor­bett was granted a waiver to move for­ward with his ver­sion of Med­i­caid cov­er­age, of­fi­cials at the Cen­ters for Medi­care and Med­i­caid Ser­vices did elim­i­nate such con­tra­dic­tory con­di­tions of his pro­posal as pre­mi­ums on the very poor, work search re­quire­ments and ex­treme re­duc­tion in ben­e­fits. Se­nior cit­i­zens and ex­ist­ing Med­i­caid en­rollees such as preg­nant women and dis­abled in­di­vid­u­als could still lose ben­e­fits un­der Cor­bett’s pro­posal, the fine points of which still must be ham­mered out with fed­eral of­fi­cials.

Cor­bett in­sists that his ver­sion of Med­i­caid cov­er­age will save tax­pay­ers more than $4 bil­lion over the next eight years. How­ever, a study by the Kaiser Fam­ily Foun­da­tion es­ti­mated that ex­pand­ing Med­i­caid would save Penn­syl­va­nia $878 mil­lion in un­com­pen­sated care costs alone be­tween 2013 and 2022 and re­sult in $43 bil­lion in fed­eral money com­ing into Penn­syl­va­nia over a 10-year pe­riod.

Not sur­pris­ingly, Penn­syl­va­nia Cham­ber of Business and In­dus­try mem­bers have applauded Cor­bett’s Healthy PA plan be­cause, they say in a press re­lease, it is “vi­tal in con­trol­ling state spend­ing and fight­ing new taxes on em­ploy­ers.”

We dare­say those mem­bers also support Cor­bett’s re­fusal to levy an ex­trac­tion tax on Mar­cel­lus Shale drillers that could pro­vide bil­lions of dol­lars to help con­trol state spend­ing, as is done in ev­ery other oil-pro­duc­ing state. In­stead, in Penn­syl­va­nia, it is be­ing done at the ex­pense of cit­i­zens’ health.

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