Capitolwire: Sens. Corman, Vance leading Senate GOP review of potential Medicaid Expansion.

February 27, 2013

Speaking of Medicaid expansion, Senate Appropriations Committee Chairman Jake Corman, R-Centre, says Gov. Tom Corbett “has left the door open to it.” Sen. Pat Vance, R-Cumberland, says the key will be getting sufficient “concessions” from the federal government, “as other states have done, but ones that fit Pennsylvania’s needs, as other states have fitted the program to their needs.”

By Peter L. DeCoursey, Bureau Chief, Capitolwire

HARRISBURG (Feb. 26) – Senate Appropriations Committee Chairman Jake Corman and Senate Health and Welfare Committee Chairwoman Pat Vance, R-Cumberland, are leading a Senate GOP review of Pennsylvania potentially joining the Medicaid expansion.

Corman, R-Centre, said that “many members” of the Senate’s 27-member Republican majority “have a lot of interest in this issue, and my staff, working with Sen. Vance and other senators, are working on this issue, to get the information our caucus needs to have a full discussion and come to a decision.”

Proponents say the plan will bring $3 billion in federal funds to the state annually to provide health insurance for up to 500,000 uninsured poor Pennsylvanians. Critics say the feds lack the funds to pay for it, and states are likely to end up paying more for fewer benefits than are now promised.

The 23-member Senate Democratic caucus, led on this issue by Minority Leader Jay Costa, D-Allegheny, and Senate Minority Appropriations Committee Chairman Vince Hughes, have made a top policy priority in having the state join Florida, Ohio, and Pennslvania’s other neighboring states in the Medicaid expansion.

Asked about Medicaid expansion in light of New Jersey GOP Gov. Chris Christie announcing his state would expand its Medicaid program, Corbett administration spokesperson Christine Cronkright wrote in an email: “Neither Governor Christie’s decision, nor those of other Republican governors, have changed Gov. Corbett’s decision. The questions and concerns that the Governor posed in his letter to HHS are still outstanding, and he remains concerned about the cost of expanding Medicaid in Pennsylvania without reforms.”

While Corbett has said the federal government refuses to provide sufficient information, Hughes noted during the Health department’s budget hearing today, that they provided “sufficient detail so the governors of New Jersey, Florida, Ohio and Arizona are all expanding Medicaid. And we should too.”

Corman responded later that was an attempt to politically pressure the issue by portraying Corbett as ‘surrounded,’ and countered that this was a policy decision demanding careful review of the facts: “I respect those governors and I am not saying they made a bad decision. We’re making our own analysis of the situation for Pennsylvania¬† and will make our own decision.”

Corman and Vance spoke after the hearing. Corman said he believed the Senate GOP, working with the governor and very likely the House GOP, would take a position before the passage of the state budget in late June. House Democratic leaders have joined the Senate Democrats in calling for the Medicaid expansion.

Several Republican senators have said there is support for Medicaid expansion in their caucus, but Vance said Corbett was right to want to get full information and negotiate Pennsylvania’s entrance into the program, as the governors of the other states did.

Florida got concessions on its programs for children’s health, Vance said, and Pennsylvania should seek concessions on its welfare programs. As part of the overall Affordable Healthcare Act, welfare benefits remain the same as before that law, known as ObamaCare, took effect. That means Pennsylvania pays more than federal benefits for many welfare programs, she said.

Getting a waiver so that the federal benefit level applies under a Medicaid expansion, not the mandate to keep the higher state benefits for current enrollees, is the kind of concession the state should ensure it gets before signing up, said Vance.

“I think we need to get some concessions first,” said Vance, R-Cumberland. “For example, we can’t get clarity on whether CHIP kids” covered under the state-federal program for poor children’s health care, would be covered by the expansion.

“We need answers to those questions and we should be able to get them to make a decision,” Vance said.

Corbett, while being unrelentingly negative on the issue, has never said the state will not expand, only that he doesn’t know how the federal government will afford it and questioned whether the federal government will keep its promise to pay for all of it the first three years and 90 percent thereafter.

One GOP senator who wants the state to join the expansion, after it wins the kinds of concessions outlined by Vance, worried: “The question is, will this governor change his mind? He can be awfully stubborn and while he has never said no, I think he thinks he has been saying no, and this is the kind of issue he may dig in on.”

Other senators said they believe the hospital industry, which made enormous concessions financially when negotiating the federal law, will prevail on Corbett, once he secures concessions.

But Sen. Jim Ferlo, D-Allegheny, used the Health department budget hearing to accuse the administration and governor of “a conspiracy to intimidate the provider community” into not pushing hard for Medicaid expansion. Acting Health Secretary Michael Wolf, challenged by Ferlo to say if he was part of this administration conspiracy or not, appeared taken aback by the question.

After a brief silence, Corman laughed and advised him: “Just say no.”

The Hospital Association of Pennsylvania has been very active on behalf of the law and appeared unintimidated.

While other states have won concessions before signaling they would join the expansion, Vance and others have noted that each state’s Medicaid program is different, so that states need to negotiate individually with the federal Department of Health and Human Services.


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