Corbett needs to cut Pa. in on the deal
Even as Welfare Secretary Beverly Mackereth contended recently that the state government would not expand Medicaid until 2015 - if at all - Pennsylvania's hospitals reported that in the 2012 fiscal year, the amount of uncompensated care they provided exceeded $1 billion for the first time.
According to the Pennsylvania Health Care Cost Containment Council's annual report on hospital finances, hospitals statewide provided $1.037 billion for which they were not paid, a 6.4 percent increase over 2011. The fiscal year closed June 30.
Medicaid expansion is a primary means by which the federal Affordable Care Act would expand health care coverage. It would increase Medicaid eligibility to 133 percent of the federal poverty standard. A family of four with gross annual income of $34,000 a year would become eligible for Medicaid, for example.
Medicaid is a federal-state program. The law calls for the federal government to pay for 100 percent of the expansion costs for two years and 90 percent thereafter - a tremendous deal for state governments. But Gov. Tom Corbett appears willing to forgo that coverage expansion, the increase in health care access it would create for low-income workers and families, and the $4 billion a year it would infuse into the state's economy.
Mr. Corbett has cited uncertainty about the law's impact, despite many independent studies concluding that the Medicaid's economic impact overwhelmingly would be positive.
There are political implications, as well. The ACA is scheduled to take effect Jan. 1, the beginning of a gubernatorial election year. Mr. Corbett, who joined other Republican governors in the failed federal lawsuit against the ACA, has low poll numbers and can't afford to alienate his conservative base by embracing "Obamacare."
Anticipating that state governments would not be foolish enough to reject the federal offer, the hospital industry agreed, during negotiations on the new law, to reductions in Medicare reimbursements that are used to help cover uncompensated care. Next year, when the ACA takes effect, that number is scheduled to decline by $500 million nationally and by $34 million in Pennsylvania. The administration announced this week that it will hold off on that reduction, in states where Medicaid expansion is rejected, until 2015.
Taxes and health insurance premiums inevitably reflect the costs of uncompensated care. Rather than having Pennsylvania taxpayers help pay for better health care access and healthier hospitals in other states, the governor should cut in Pennsylvania on the good deal.