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Capitol reporter Katie Meyer covers Pennsylvania politics and issues at the Pennsylvania state capitol.
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New DPW chief underscores Medicaid expansion not ruled out

Written by Mary Wilson, Former Capitol Bureau Chief | Mar 6, 2013 11:01 PM
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This post was updated at 9:27 a.m. 3/7/2013.

Talks on a possible Medicaid expansion appear to hinge on a meeting that isn't on the governor's schedule yet and bickering over dueling cost estimates and whether to trust a federal IOU.

Gov. Corbett said during his budget address last month that one of the reasons he's not deciding "at this time" to expand Medicaid is because he's not sure he can count on federal dollars to foot all of the costs in the first few years and most of the costs thereafter.

The acting secretary of the state Department of Public Welfare has borrowed that argument. Bev Mackereth told the House Appropriations Committee Wednesday it's not wrong to doubt the federal government's ability to deliver on funding promises, because they've been broken before.

"Special education - the commitment from the federal government was 40 percent, we're now down at 17," said Mackereth, offering an example. "I know you all are struggling with that piece in the education portion of your budget."

But Senate Democrats say that's disingenuous, arguing that special education is not an entitlement program like Medicaid, Medicare, or Social Security - all of which the federal government has a legal obligation to cover.

"The governor did not say no," said Mackereth about the possible expansion of Medicaid to include most people who earn 133 percent(effectively 138 percent) of the federal poverty level. "The governor said that we need to talk to the federal government about flexibility and reform." Mackereth added that she's not sure it would have been better for the administration to begin earnest talks with the federal government any sooner, because seeing what kinds of demands other states are making "will be helpful."

In hearings with House and Senate lawmakers, Mackereth has also stressed that the fact that other states are expanding their Medicaid programs has no bearing on whether Pennsylvania should, saying
Pennsylvania's population makes its program more costly to expand.

"Today, 2.2 million Pennsylvanians - one in six--are on [Medical Assistance]," said Mackereth Wednesday. "If we do the expansion to 133 percent of the federal poverty level, we will have three million Pennsylvanians on MA, which means one in four."

The Obama administration has committed to funding 100 percent of the costs of the first three years of a Medicaid expansion, beginning in 2014. Corbett's cabinet members insist costs to the state would total $4 billion through 2022, but the nonpartisan Kaiser Family Foundation puts it at $2 billion.

The governor, for his part, has said he won't budge on Medicaid without more assurances from the feds. He plans to meet with U.S. Health and Human Services Secretary Kathleen Sebelius, but so far, nothing has been scheduled.


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