To boos, cheers, Corbett rejects expanding Medicaid rolls

February 06, 2013|By Amy Worden, INQUIRER HARRISBURG BUREAU

HARRISBURG – Simultaneous boos and cheers broke out among legislators in the House chamber on Tuesday when Gov. Corbett said he had no immediate plans to expand Medicaid eligibility for low-income Pennsylvanians under the federal Affordable Care Act.

The partisan reaction – among the strongest during his 45-minute budget speech – continued with instant news releases and social-media cheers and jeers, underscoring the political battle that still lingers concerning the federal health-care overhaul known as Obamacare.

Corbett won plaudits from fellow Republicans and criticism from Democrats for rejecting – at least for now – the addition of about 500,000 residents to Medicaid rolls, an option made available by the new law.

The governor said he had written to Kathleen Sebelius, secretary of health and human services, telling her that without flexibility, the costs to implement an expanded Medicaid program would be prohibitive.

“At this time, without serious reforms, it would be financially unsustainable for Pennsylvania taxpayers, and I cannot recommend a dramatic Medicaid expansion,” Corbett said in his annual budget speech.

Republicans called the move fiscally responsible. Democrats denounced him for not taking the opportunity to provide insurance for low-income residents and passing up $12 billion in federal funds available in the first three years of the program.

“This would mean a half a million people would get insurance, it would take the burden off hospitals, and it would mean a largest injection of economic development dollars,” said State Sen. Vincent Hughes (D., Phila.).

But House Majority Leader Mike Turzai (R., Allegheny) said expanding Medicaid eligibility now would surely lead to a tax hike later as federal subsidies decline, leaving the state to pick up a total of $4 billion by 2022, according to Corbett administration estimates. “We would have to raise taxes down the road,” Turzai said.

A new report by the Henry J. Kaiser Family Foundation offered a less dire forecast, estimating Pennsylvania’s costs for new Medicaid enrollees at $2.8 billion by 2022, while the federal government would provide $37.8 billion during that time period.

Corbett’s announcement comes on the heels of a decision by one of his Republican counterparts, Ohio Gov. John Kasich, to opt into the Medicaid expansion plan, as Republican chief executives of three other states have done.

The wording of Corbett’s speech appeared to leave open the possibility, though, that if the Obama administration were to build more flexibility into the program, Corbett might shift his stance.

Medicaid expansion was one of the hallmarks of the controversial health plan approved by Congress in 2011 and upheld last year by the U.S. Supreme Court. A total of 19 states and the District of Columbia have opted into the program. Enrollment for families of four earning up to $31,800 begins in October and money begins flowing to the states in January.

Under the expansion, the federal government covers 95 percent of the costs in the first three years, with the state’s share increasing in future years.

Contact Amy Worden at 717-783-2584 or or follow @inkyamy on Twitter.

Kathleen Sebelius: Medicaid expansion’s not ‘bait and switch’

By: Jason Millman
February 5, 2013 04:38 AM EST
In a message targeted at states undecided about expanding Medicaid under the health care law, Department of Health and Human Services Secretary Kathleen Sebelius stressed Monday that the White House won’t back away from its promise to fund the expansions, even amid mounting battles over the federal budget.

Sebelius said states hesitant to sign up for the Medicaid expansion under the Affordable Care Act shouldn’t fear that the federal funding commitment will disappear when states boost their Medicaid rolls.

“This isn’t a bait and switch,” Sebelius told reporters Monday morning after addressing a health care conference in Washington. “We’re not saying come in, and we’re going to change the underlying framework.”

Sebelius spoke just hours before Ohio’s Gov. John Kasich became the fifth Republican governor to officially support the Medicaid expansion. Kasich, a former House Budget Committee chairman who has rejected a state-run health insurance exchange, said the decision would allow the state to direct its health care dollars toward mental health and other services.

Under the president’s health care law, the feds promised to fully fund the newly eligible population for three years starting in 2014. That match rate eventually will be nudged down to 90 percent over a decade, which is still significantly higher than the feds’ 57 percent average matching rate for the existing Medicaid program.

“I’d say it’s as good a deal as any state is going to get,” Sebelius said in prepared remarks at the National Health Policy Conference.

Many states, including some with governors who are big Obamacare backers, are worried that escalating federal budget battles will force major cuts in federally funded health care programs. So while the matching rate is much better than the norm, they’re skeptical it can last.

But the administration is drawing a hard line on Medicaid to prod more states to expand. Sebelius commented a few days after Gene Sperling, a top White House economic adviser, told a separate conference of health care advocates that President Barack Obama won’t support any major Medicaid cuts for the remainder of his administration.

“There’s a nervousness — an understandable nervousness — what if governors come into this system and then the federal budget deal changes the formula?” Sebelius said. “I think the president has made it very clear he understands this framework of payment is essential to giving governors the confidence that he’d oppose any change in that framework.”


Michigan Republican governor Snyder backs Medicaid expansion

Wed, Feb 6 2013

By Mary Wisniewski

(Reuters) – Michigan Governor Rick Snyder on Wednesday endorsed an expansion of health coverage for the poor under President Barack Obama’s reform law, joining five other Republican governors who have agreed to widen the Medicaid program in their states.

Snyder made his announcement at a hospital in the state capitol of Lansing.

“This makes sense for the physical and fiscal health of Michigan,” Snyder said in a statement.

He said the move will add 320,000 state residents in the first year, and more than 470,000 by 2021, cutting the number of Michigan uninsured almost in half.

Snyder joins fellow Republican Governor John Kasich of Ohio, who made his Medicaid expansion announcement on Monday. The Republican governors of Arizona, Nevada, New Mexico and North Dakota had previously said they would expand the program.

It also follows new assurances that the Obama administration will defend federal funding for the program in upcoming deficit reduction talks with Congress.

Snyder is expected to unveil his budget for fiscal 2014, including the Medicaid program changes, on Thursday.

Obama’s Patient Protection and Affordable Care Act calls on states to expand Medicaid to most Americans earning up to 133 percent of the poverty line. The expansion would revolutionize the program, which in many states is now limited mainly to children, pregnant women and the very old. Under the reform law, Washington would fund more than 90 percent of the expansion.

Analysts say pressure on states from local healthcare industries, combined with a new Republican interest in appealing to minority voters in the wake of Obama’s re-election, has nudged some governors toward acceptance.

Ron Pollack of Families USA, a Washington-based consumer healthcare advocacy group, said the decision by Michigan and Ohio’s governors will provided health coverage to “well over a million uninsured people.”

“It is also indicative of an inevitable movement that will ultimately result in Medicaid expansions in all states across the country,” Pollack said.

The Medicaid expansion is intended to bring 16 million uninsured people into the $2.8 trillion U.S. healthcare system. But many states, which would pay less than 10 percent of the cost under the law, have balked at the potential budget impact or rejected the prospect of participating in a new government program.

Since Obama’s re-election, at least 10 governors have chosen to support the Medicaid expansion, including six Republican governors. Five Republicans have chosen to oppose it.

Another 14 governors, 12 Republicans and two Democrats, remain undecided, but experts say many are likely to reach decisions in the coming weeks as they propose new budgets for the fiscal year beginning July 1.

Snyder was joined at the announcement by business, consumer and human service groups, including the Michigan Health & Hospital Association and the state’s Small Business Association.

Snyder said more than $20 billion will come into Michigan through 2023 by leveraging federal funds made available through the Affordable Care Act, and that the state’s General Fund will see $1.2 billion in savings through 2020.

“The bottom line is that expanding eligibility for coverage in the state’s Medicaid Program will save lives, save money and lead to a healthier population,” said Kim Sibilsky, executive director of the Michigan Primary Care Association.

Michigan House Speaker Jase Bolger, a Republican, said in a statement he remained “cautious and concerned” on behalf of taxpayers regarding the Medicaid expansion.

“The federal government has a history of working with states to start long-term programs while providing only short-term funding, and then sticking state taxpayers with the future financial liability that program creates,” Bolger said.

(Reporting by Mary Wisniewski in Chicago; Editing by Greg McCune and Eric Walsh)

Insurance brokers to fight for state health exchange

Feb 6, 2013, 1:44pm EST

By: David A. Mann

Business First


Health insurance agents and brokers plan to lobby against legislation that would keep the state from establishing a health insurance exchange. The exchange, a product of the Patient Protection and Affordable Care Act, is to serve as a marketplace for those seeking insurance policies.

The legislation prohibiting the state from operating an exchange unless authorized by the General Assembly was introduced by Kentucky Sen. Julie Denton, R-Louisville, in January. It undermines an executive order issued in July by Democratic Gov. Steve Beshear to move forward with establishing the exchange.

Residents in states that do not create their own health insurance exchanges can use a federal health insurance exchange.

Leigh Ann Thacker, a lobbyist for an agent and broker trade group called the Kentucky Association of Health Underwriters, said if Kentucky residents are to participate in an exchange, it should be one administered by state government, rather than federal government.

Though not all the details have been finalized, agents are expected to be allowed to sell policies that are offered through the Kentucky Health Insurance exchange.

Additional reading on the exchange and its impact can be found here.

David A. Mann covers these beats: Health care, health insurance, distribution/logistics (UPS), manufacturing (GE, Ford), environment, travel, minority/women’s affairs and Southern Indiana.


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