Perhaps Gov. Tom Corbett will get lucky. Maybe the bungled launch of the Healthcare.gov website will cause federal regulators to accept state alternatives to the Obamacare Medicaid plan for the sake of boosting enrollment, no matter how bad the state plan.

But even if the feds approve the many waivers from federal requirements sought by the governor, Pennsylvanians wouldn't begin to realize his plan's marginal benefits until 2015. Meanwhile, beginning Jan. 1 when the new health care law takes effect, the governor's refusal to readily expand health care access will cost Pennsylvania $10 million a day in direct federal benefits and related economic activity, according to several separate studies.

Under Obamacare, the federal government pays 100 percent of the cost for three years, and 90 percent of the cost thereafter, of expanding Medicaid to cover low-income workers who earn too much for conventional Medicaid but not enough to buy their own insurance. It's a great deal that has been embraced by several other Republican governors, including Gov. Chris Christie of New Jersey. Thus, substantial federal benefits to cover low-income workers and ensure payment to health care providers will begin flowing into New Jersey this week, but not into Pennsylvania.

Rather than accepting the straightforward federal proposal, Mr. Corbett has concocted a complex hybrid that needlessly would funnel federal money through private insurers while contradicting the very purpose of the federal initiative. It would impose significant premiums on enrollees, even though the federal plan was created to help people who can't afford premiums. It also would require proof that unemployed enrollees are seeking work, even though the Labor Department says there are 2.9 available workers for every available job.

Failure to expand Medicaid also contributes to rising premiums for covered Pennsylvanians, because the costs of treating uninsured people are rolled into hospitals' and doctors' costs that show up in insurance rates.

Federal regulators recently rejected an Iowa plan that had a premium structure similar to that proposed by Mr. Corbett.

As of Jan. 1, about 2 million Americans who did not have health care will be covered, despite the problems with the Affordable Care Act launch. None of them will be Pennsylvanians.

State lawmakers should move aggressively to correct Mr. Corbett's wayward diagnosis so that as many Pennsylvanians as possible gain access to health care and the state economy gains from the resulting increased economic activity.