A day after Florida Republican Gov. Rick Scott reversed course and agreed to participate in a federal Medicaid expansion, two consumer groups pressed Pennsylvania Gov. Tom Corbett to do the same.
Mr. Corbett has been wary of participating in the expansion because he wants more flexibility than the federal program would allow.
Families USA and the Pennsylvania Health Access Network put out a report Thursday estimating that participation would bring 41,200 jobs and $5.1 billion in increased economic activity to the state. The figures represent additional health care workers and money providers will spend to expand their facilities as well as the impact on other industries where those workers and companies may spend their wages and profits.
The expansion also would reduce the state's uncompensated care costs by $878 million over the next nine years by providing coverage to uninsured Pennsylvanians whose emergency medical care is now borne by taxpayers, according to the study.
State officials said they will review the study's data with stakeholders, but their biggest concern is reforming the existing program, which incurs costs not in line with fiscal realities.
"We will continue to examine reforms and program changes that could meet the unique needs and diversity of Pennsylvania's citizens and make the program work more efficiently for beneficiaries and the state," said Anne Bale, spokeswoman for the state Department of Public Welfare. "It may be possible for Pennsylvania to provide affordable health care to more of its citizens, but only if we are allowed to pursue meaningful reforms and program flexibility."
Meanwhile, Families First and the Pennsylvania Health Access Network say it's irresponsible to decline to participate in the federal expansion.
"Any governor that rejects the Medicaid expansion is committing fiscal malpractice," said Ron Pollack, executive director of Washington-based Families USA.
"The Medicaid expansion is a win-win-win proposition for the people of Pennsylvania. It would reduce the number of people who can't afford health care, it will increase the number of jobs throughout the state and it will strengthen the state's economy," he told reporters on a conference call Thursday.
Meanwhile, Pennsylvania House Democrats gathered Thursday to hear from other consumer advocates and health experts at a public hearing on the Medicaid expansion.
"Accepting federal funds for Medicaid expansion would be a great economic driver in the Pittsburgh region and throughout Pennsylvania by allowing for the creation of potentially thousands of quality, good-paying jobs in the health care sector," state Rep. Dan Frankel, D-Squirrel Hill, said in a statement after the hearing.
The expansion is part of the Affordable Care Act. Participation, which is optional because of a U.S. Supreme Court ruling, would require states to increase income limits for eligibility in order to receive federal help to pay for the additional enrollees.
The federal government would bear 100 percent of the increased costs for the first three years. After that the federal share would gradually decrease to 90 percent.
If Pennsylvania participates, it would spend $2.8 billion in state tax dollars to leverage $37.8 billion in federal funds over 10 years, according to the Kaiser Family Foundation, a nonpartisan Washington think tank.
Ms. Bale, though, said the state would incur additional costs -- as much as $4 billion during that time period.
She said the state would incur additional staffing and administrative costs to serve an estimated 800,000 new recipients. She said the state also anticipates additional costs of new enrollees who already were eligible but hadn't signed up, and for workers who drop out of employer-provided or self-funded insurance plans in order to enroll in the taxpayer-funded program.
In a letter earlier this month to U.S. Health & Human Services Secretary Kathleen Sebelius, Mr. Corbett said Pennsylvania's Medicaid program is on an unsustainable path. He said the state could provide Medicaid coverage to more Pennsylvanians on its own if it had more independence and flexibility than what the Affordable Care Act offers.
The federal government now pays 54 percent of Medicaid costs for current enrollees, who are among the very poorest of Pennsylvanians. A family of three, for example, must have income below $8,524 to be eligible, according to a study last year by the Kaiser Foundation.
Under the expansion, a family of three could earn up to $26,344 and remain eligible. The expansion also would make childless adults eligible for the first time if their income is below $15,028.
The current Medicaid program already covers some 2.2 million Pennsylvanians at a cost of $21.9 billion a year, including $14 billion of that coming from the federal government.
In Florida, Mr. Scott had been a strong opponent of the Affordable Care Act, but on Wednesday he said it made sense to participate in the Medicaid expansion at least in the initial phase when the federal government would bear the full cost of covering new enrollees who hadn't been eligible before.
Earlier, Mr. Scott and other Republican governors had questioned whether Medicaid costs would increase too quickly and states would be on the hook for more money than anticipated. Now, several of those governors have agreed to participate, at least for now.
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