Claiming that the new federal health care law doesn't offer enough flexibility to states, Gov. Tom Corbett this week said Pennsylvania will not participate in a key aspect of it.
If he follows through, he will leave billions of federal dollars on the table, hundreds of thousands of Pennsylvanians without health insurance and beleaguered hospitals and other health care providers without a key source of revenue.
One of the key ways that the federal law would expand health coverage is to expand eligibility for Medicaid to cover low-income workers who earn too much to be eligible now but not enough to pay for their own health insurance.
For the first three years of the expansion, the federal government would cover 100 percent of the costs. From that point, it would cover 90 percent and the state government would cover the other 10 percent. It would be a great deal for the state government, transcending the "flexibility" issue raised by Mr. Corbett because it would relieve the state of the vast majority of costs.
The Corbett administration has estimated the state government's total costs at $1 billion by the end of 2016, but other analysts have said it would be lower. The Urban Institute, for example, has estimated the state cost at $2 billion over 10 years.
As many as 600,000 uninsured Pennsylvanians could remain so due to the decision, but that doesn't mean that won't get sick and receive care. But hospitals and some other providers won't get paid for it, and the cost eventually will be rolled in to bills and health care coverage paid by others.
Republican governors in Arizona, Nevada, New Mexico, North Dakota and Ohio have decided to participate in the Medicaid expansion.
Lawmakers should not allow the governor to walk away from billions of dollars that could help resolve coverage for hundreds of thousands, while helping hospitals meet their obligations.