HARRISBURG - Pennsylvania Gov. Tom Corbett became the 10th Republican governor Monday to support accepting federal Medicaid expansion dollars to insure hundreds of thousands of working poor, although it remained to be seen how the Obama administration will respond to a list of demands Corbett wants satisfied.
Corbett's Medicaid proposal was submitted to the U.S. Department of Health and Human Services on Monday. It came after months of discussion between the two sides and heavy in-state pressure on Corbett to embrace a Medicaid expansion from groups including the AARP, labor unions, hospital executives, and even the Republican-controlled state Senate.
For starters, Corbett, a conservative and a staunch critic of Medicaid who sued to overturn President Barack Obama's signature health care law, will insist that Pennsylvania get a deal similar to one already being sought by Iowa and Arkansas.
Under that scenario, federal Medicaid expansion dollars would pay the premiums for newly eligible adults to get private insurance in a new health care marketplace instead of being used to expand the traditional Medicaid coverage that typically pays lower reimbursements to doctors and hospitals. As a result, he insists that his overture to the federal government would not result in a Medicaid expansion, something that he says he opposes.
In addition, he wants to pare back benefits for able-bodied adults who are already on Medicaid and require the unemployed and able-bodied who are seeking Medicaid coverage to submit to search for work through an online job clearinghouse set up by the Corbett administration.
Pennsylvania cannot afford to expand the existing Medicaid program that already covers one in six people, including children and the elderly in nursing homes, Corbett said in a news conference at Harrisburg Hospital to announce his plan. But he insisted that his administration has come up with a better and more affordable answer for Pennsylvania than Washington can.
"If the goal is to give everybody quality and affordable health care, this is Pennsylvania's way of doing that," Corbett said.
He also dismissed questions about things like the work search requirement, saying it was not about creating barriers, but rather about reaching out to people and helping them find ways to get health insurance.
Corbett said the proposal had been crafted in a way that would not require legislative approval.
The federal Medicaid expansion dollars become available Jan. 1. But it is not yet clear not only whether the Obama administration will agree to Corbett's conditions, but how long it will take to come to an agreement.
In addition, Corbett's public welfare secretary, Beverly Mackereth, has said that the administration will probably need until 2015 to negotiate and prepare for a Medicaid expansion plan, even if Pennsylvania agrees to accept the dollars.
Other Republican governors who support a Medicaid expansion include two in neighboring states, Chris Christie in New Jersey and John Kasich in Ohio.