Pennsylvania won't make Medicaid available to more of its poor residents, Gov. Tom Corbett (R) told state legislators during his budget address Tuesday.
By rejecting the Medicaid expansion under President Barack Obama's health care reform law, Corbett becomes the 11th Republican governor to turn down federal funding to provide health benefits to low-income residents. Pennsylvania now joins Idaho, Maine and a swath of states from Georgia to Texas in refusing to add more people to Medicaid, which is jointly managed and financed by the federal and state governments.
The health care reform law seeks to enroll as many as 17 million people earning up to 133 percent of the federal poverty level, which is $15,282 this year, to Medicaid -- but the goal is being undercut by Pennsylvania and other states that refuse to participate. The Supreme Court ruling that upheld Obama's health care reform law last year also enabled states to opt out of the Medicaid expansion, which the Congressional Office says will result in about 3 million people losing out on health benefits over the next decade.
Echoing the rationales of GOP governors like Idaho's C.L. "Butch" Otter and Texas' Rick Perry, Corbett said Pennsylvania shouldn't enlarge its Medicaid program without a major overhaul of the program.
"At this time, without serious reforms, it would be financially unsustainable for the taxpayers, and I cannot recommend a dramatic Medicaid expansion," Corbett told legislators, according to the text of his prepared remarks published by the Associated Press. "The federal government must authorize real flexibility and innovative reforms that empower us to make the program work for Pennsylvania."
Corbett reiterated that demand in a letter delivered to Health and Human Services Secretary Kathleen Sebelius Tuesday. He also said that the Obama administration hasn't provided clear guidance to enable the state to predict its share of the costs of expanding Medicaid.
Republican governors in 11 states are turning down the Medicaid expansion despite generous federal support. Under the health care reform law, the federal government will pay 100 percent of the costs to cover newly eligible people from 2014 through 2016, after which the funding will diminish until it reaches 90 percent in 2022 and later years.
The Obama administration has sought to allay concerns expressed by governors that this level of financing, which compares to an average 60 percent federal share for the cost of current Medicaid beneficiaries, will be stable. On Monday, Sebelius said the administration is committed to maintaining full funding of the Medicaid expansion, following an assertion last week by Gene Sperling, director of the National Economic Council, that the White House will oppose any funding cuts to Medicaid during the next rounds of budget negotiations with congressional Republicans.
Corbett's announcement comes a day after fellow Republican governor John Kasich of Ohio became the fifth GOP state executive to back the Medicaid expansion. In contrast to Corbett's claims about the affordability of adding more people to Medicaid, Kasich, Arizona Gov. Jan Brewer (R) and others have cited the high level of federal funding as a key reason to participate. The chief executives of 20 states and the District of Columbia now support the Medicaid expansion.
A Medicaid expansion in Pennsylvania would extend health coverage to 542,000 newly eligible people by 2022, according to a report published in November by the Urban Institute and the Henry J. Kaiser Family Foundation. Pennsylvania's share of the costs for these new enrollees would total $2.8 billion, and the federal government would send $37.8 billion to the state over that time, the analysis says.
Corbett previously rejected another element of Obama's health care reform law. Pennsylvania will be one of 25 states that will defer to the federal government rather than establish its own, state-based health insurance exchange. These marketplaces will be the gateways for individuals and small businesses to comparison shop for health coverage and to find whether they are eligible for financial assistance or Medicaid benefits.
READ GOV. TOM CORBETT'S LETTER TO HEALTH AND HUMAN SERVICES SECRETARY KATHLEEN SEBELIUS: