Gary Alexander, the Corbett administration official who oversees Medicaid, took a trip to Capitol Hill in December to testify on one of the most divisive issues in the country, the Affordable Care Act. Speaking to federal legislators, he noted that Pennsylvania will delay its decision about expanding Medicaid for adults until they have the flexibility to create a program that increases affordable and cost-effective coverage. Alexander cited "hundreds" of federal mandates that will cost money and manpower that he believes Pennsylvania does not currently have. Alexander said the Affordable Care Act was a way for the government to micromanage the states, claiming that "We in the commonwealth have never witnessed a law so vast with such demands on state resources, and lack of federal guidance."
The hearing, in which Alexander was joined by counterparts from Louisiana and Wisconsin, was centered on Obama's plan to allow states to expand Medicaid eligibility. All three blasted the law and its costs. The federal government will pick up all coverage costs to start, and 90% of the tab from 2020 forward. While Democrats say the plan will help states provide coverage to the many uninsured people with relatively low costs, Republicans say that ten percent of a huge number is still a very large number. And given the persistent federal deficits, Corbett questioned whether Washington will be able to keep its promise.
There wasn't just negativity at the hearing. Praise could be heard from officials from the Obama administration, Maryland and Arkansas for the expansion and its ability to offer help to people without health coverage. Maryland Health Secretary Joshua Sharfstein said his state is projected to save nearly $2 billion because of the expansion.
Expanding Medicaid in Pennsylvania would help an estimated 542,000 new Pennsylvanians enroll, at a cost of an additional $2 to $4 billion. By the state fiscal year 2020-2021, the estimated cost will be $883 million. According to a study by the nonpartisan Kaiser Foundation, the federal government would pay an additional $37.8 billion over the next decade to help cover Pennsylvanians. The expansion from the Affordable Care Act will cause for more than 40 percent of the population on a federal healthcare program, a number about the size of the total employment number in Pennsylvania.
Also at the hearing, Alexander faced sharp questions about why 89,000 children were dropped off Medicaid between August 2011 and January. Alexander responded, saying the review was to make sure only those who are eligible were enrolled and noting that those removed were allowed to reapply.
For Alexander's full report, click here.
UPDATE: Pennsylvania still remains undecided, but other states have made their decisions. Check out this map below for the Medicaid Expansion decisions as of January 3, 2013.
