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Pennsylvania GOP Governor Appears Ready to Embrace Medicaid Expansion

By Rebecca Adams, CQ HealthBeat Associate Editor

September 12, 2013 -- Pennsylvania Republican Gov. Tom Corbett appears to be on the cusp of announcing his support for an expansion of Medicaid, according to advocates.

Corbett has faced tremendous pressure from medical providers, the seniors' group AARP and consumer advocates to support a broadening of the program for people in households with income of up to 138 percent of the federal poverty line as is called for in the health care law (PL 111-148, PL 111-152).

State officials did not immediately respond to requests for comment.

Advocates who have heard of Corbett's support said he would announce his change in position next week.

In February, Corbett said, "At this time, without serious reforms, it would be financially unsustainable for the taxpayers, and I cannot recommend a dramatic Medicaid expansion."

But after Secretary of Public Welfare Gary Alexander, a sharp critic of expansion, left his post after Corbett's February speech, the Corbett administration has been holding talks with federal officials about the possibility of expansion.

The closely divided Pennsylvania legislature is controlled by Republicans. Democrats, both in the statehouse and in Congress, along with some Republicans, have pushed Corbett to expand the program.

Starting in January, the federal government will pay states 100 percent of the costs for the newly eligible Medicaid recipients. That federal matching aid declines to 90 percent by 2020.

While the framers of the health overhaul envisioned that Medicaid would be expanded throughout the country, last year's Supreme Court decision on the overhaul paved the way for each state to decide whether to expand. So far about half the states have decided to broaden Medicaid eligibility.

State officials have said any expansion would have to be coupled with changes, similar to what has been proposed in Arkansas, that would allow Medicaid dollars to be used for private coverage in the exchanges. Federal officials appear inclined to support that. The governor also would like to ask patients for co-pays for the emergency room that are significant enough to deter overuse. That would be allowed under the health law for people who are newly eligible for Medicaid.

"Governor Corbett does not support growing an entitlement program and has been very clear about the need for Medicaid reform," Christine Cronkright, a spokeswoman for Corbett, said in an email. "There are a number of interesting options that the state has been considering to ensure access to quality, affordable healthcare. The Governor will have more to say on this issue sometime next week."

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