Pa. Lawmakers Look at Medicaid Expansion

By Melissa Daniels | PA Independent

HARRISBURG — Lawmakers are just beginning the debate on whether to expand Medicaid in Pennsylvania, and so far, the discussion sits on partisan lines.

This week, Majority Whip Rep. Stan Saylor, R-York, said he plans to introduce a bill that would block the controversial expansion of Medicaid under the federal Patient Protection and Affordable Care Act.

“Expanding Medicaid is the wrong course of action and is a disaster in the making. Adding more people to Medicaid is not something we should aspire to nor celebrate,” said Saylor in a memo circulated to House legislators. “It is not the way to address the uninsured population.”

In June, the U.S. Supreme Court ruled a portion of ACA unconstitutional that said any state that did not expand coverage would lose its entire federal Medicaid funding. The ruling allows states to decide whether to participate in expansion without penalty.

Citing the high costs associated with ACA, Saylor asked his fellow legislators to co-sponsor his legislation.

Starting in 2014, the expansion would give around 750,000 Pennsylvanians new access to Medicaid, according to state Department of Public Welfare estimates. The expansion applies to those younger than 65 whose household income is at or below 133 percent of federal poverty guidelines, which equals $14,483 for an individual and $29,725 for a family of four.

A joint congressional report put Pennsylvania’s cost to implement the Medicaid expansion at more than $2 billion from 2014 through 2019.

Medicaid cost the state $4.9 billion in 2011-2012, or around 80 percent of the department’s budget including federal aid, according to the Department of Public Welfare.

But the cost of the expansion doesn’t squarely rest on the state’s shoulders. In its first three years, the expansion would be federally funded. Then, starting in 2017, federal funding would incrementally drop down to 90 percent in 2020.

Last week, Gov. Tom Corbett said the cost of the Medicaid would be “extremely high” to Pennsylvania taxpayers, and those throughout the nation.

Before Corbett was elected governor, he was one of the attorneys general who signed onto the federal lawsuit to contest the constitutionality of the law.

Minority Caucus Chairman Rep. Dan Frankel, D-Allegheny, sponsored legislation that would enable the Medicaid expansion. Given the funding structure, and the number of Pennsylvanians who would receive access to health care, it’s “a reasonable deal,” he said.

If the state opts out, Pennsylvanians who pay federal taxes will end up paying for benefits in other states, he said.

“It is a moral imperative, it makes financial sense for the state of Pennsylvania and not doing so is penalizing Pennsylvania taxpayers who will be subsidizing other states who do opt into it,” Frankel said.

Frankel said it would be “a poor decision” for the state to opt out.

Sharon Ward, executive director of the legislative think tank Pennsylvania Budget and Policy Center, said expanding Medicaid would help reimburse hospitals for uncompensated care, while other federal funding measures expire.

“It’s more dollars coming into the state going to our health-care providers,” Ward said. “It’s critically important that this occur.”