By Elana Gordon, WHYY
Fri, Oct 25 2013
Pennsylvania Gov. Tom Corbett may have kept an eye this week on his fellow Republican governor in Ohio, John Kasich, as Kasich bypassed his own Republican legislature to expand the state’s Medicaid program. As part of the Affordable Care Act, states have the option to give coverage to low-income adults, with the federal government picking up most of the tab. Only about half the states so far have planned to do that, starting Jan. 1, and Pennsylvania has, so far, not been among them.
But Corbett is now canvassing the state touting his new "Healthy Pennsylvania" plan, which calls for accepting the generous federal Medicaid dollars to expand the program, though with certain caveats.
At the St. Christopher’s Hospital for Children hospital in North Philadelphia recently, Corbett said: "We need a medical insurance program that’s designed for Pennsylvania. One size does not fit all," and outlined his concept.
Healthy Pennsylvania would direct newly eligible people, mostly low-income adults without children, into the health insurance exchange where they could buy private coverage. That’s in contrast to how it works now, where the state puts Medicaid patients into private managed care plans or sets the rates for what doctors and hospitals are paid. Corbett’s idea is to use those new federal expansion funds to help subsidize people buying their own individual plans instead.
Corbett is passionate about the reasoning behind Healthy Pennsylvania: "Most important, it’s not putting 500,000 more people into an entitlement program. It’s putting them in a program where they are invested in the program, they are invested in their health care, in a way where a person in Medicaid may not have that same personal investment,” he said.
Letting States 'Be Creative'?
Last month, the federal government approved a plan by Arkansas that allows new Medicaid recipients to shop for coverage on the insurance exchange. The Arkansas decision shows that the feds are willing to let states be creative with the expanded program. Corbett’s plan differs from Arkansas’s though, so federal approval is not guaranteed. He’d also change some current Medicaid benefits and include a job training component.
"The governor is looking for a way to draw down the federal money,” says Nicole Huberfeld, a professor of health law at the University of Kentucky. She’s not surprised by Corbett’s latest move – she believes the federal money can be too much of an opportunity for Democrat icOR Republican Governors to pass up: “The legislature may or may not be on board, but the governor recognizes a lot of federal money to be had that will likely save the state a lot of money in the long run."