Capitol reporter Mary Wilson covers Pennsylvania politics and issues at the Pennsylvania state capitol.
Legislation to compel Medicaid expansion in Pennsylvania by July 2014 has passed a key state Senate committee and is poised for another panel vote before it goes to the full Senate, but its real battle will be in the House.
The proposal allows for the expansion under certain conditions, like one very strong caveat to keep federal reimbursements in place for the move, which is expected to bring hundreds of thousands of Pennsylvanians into the program.
"We're trying to set up the parameters of what we as a commonwealth want," said Sen. Pat Vance (R-Cumberland), who led the push for expansion among Senate Republicans. "It's fine to say, 'Oh, well we want to expand Medicaid,' but we don't want to expand unless we can get some of these things... if this doesn't come to fruition, we're not going to expand."
The bill is expected to pass the full Senate, but support for it in the House is much less robust.
The Medicaid expansion language is included in a particular kind of budget-related bill that must be passed in order to put a spending plan into effect for the next fiscal year beginning Monday.
Many House Republicans sent a letter to colleagues threatening to withdraw their votes for budget legislation "if any component of the budget expands Medicaid." They said they have concerns about the cost of the expansion to the commonwealth without reforms.
But Democrats are in favor of Medicaid expansion, and House Speaker Sam Smith said Wednesday he wasn't sure opposed Republican members could muster the votes to torpedo a budget-related bill including the expansion.
Gov. Corbett has remained opposed to accepting the Medicaid expansion unless he receives assurances from federal officials to enact program reforms and reduce costs to the commonwealth.
Vance, chair of the Senate Public Health and Welfare Committee, said she's not sure if the Corbett administration supports the Medicaid expansion plan in the panel-approved legislation.
"I know they've seen it," she said. "We have kept them apprised of everything we're doing."
The omnibus bill containing the Medicaid expansion language also includes other things that would please members on both sides of the aisle. It contains a name-change for the Department of Public Welfare (it would become the Department of Human Services, something that has been pushed by Democrats and Republicans alike). The bill also contains something of a compromise on the human services block grant pilot program, expanding it from 20 counties to 30 counties.
Vance said she's not worried about the legislation's prospects in the House.
"There are so many good things in here," she said.
Sen. Vincent Hughes (Philadelphia), the ranking Democrat on the Senate Appropriations committee and one lawmaker who has made the Medicaid expansion issue his personal pet project, called the bipartisan panel vote on expansion an "important first step." He said the Corbett administration is "well aware" of the details of the proposal.
"They've had input into it," said Hughes. "We hope that we pass this out [of] the Senate, pass it out of the House, and the governor will see fit to sign it into law."
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