Is Medicaid Expansion A Good Deal For PA?
This week, GOP Gov. Chris Christie decided that the Medicaid expansion is “the smart thing to do for our fiscal and public health”. Among other GOP governors that are taking the ACA deal are Arizona’s Jan Brewer, who says it will help hospitals and care givers not adequately compensated for indigent care and Florida’s Rick Scott, who called it a common sense solution; two governors no one would argue are conservatives.
As part of the ACA (Obamacare) states can opt in to a Medicaid expansion which will cover uninsured people who make up to 133% of the poverty level ($31,800 a year for a family of 4) and be reimbursed by the federal government 100% of those expenses for the first 3 years.
It will also pay 100% of CHIP for children in families that make under the income level, something that is currently funded by the Federal government at about 66%. Mental health coverage whose costs are shouldered by not only the state, but the counties too, would be covered.
Gov Corbett has said that he can not support this because of the costs to the state down the road, but ignores these facts:
- PA can opt out, “down the road” if those expenses get too great
- The savings realized by other health care programs
- The tens of thousands (upwards of 41,000) of health care jobs created
- The increased productivity of a healthier work force (most of the new people covered, work for $10 - $12 per hour)
- Protect rural and safenet hospitals from being pushed towards bankruptcy by the growing costs of the uninsured.
- Preventative care costs way less than critical/emergency care
- The federal tax dollars Pennsylvanians pay that will go to other states.
For more information check out the Pennsylvania Budget and Policy Center.
If you agree with Gov Christie that this is the right thing to do for our fiscal and public health, please sign the TAKE THE DEAL petition.
Richard Weisgrau
4:56 pm on Saturday, March 2, 2013
Corbett seems to ignore anything that is not good for his personal agenda or political gain. A recent F&M poll showed him to have the worst approval rating of any PA Governor. He seems incapable of governing in the best sense of the word. All governors are political but Corbett seems to confuse governing with politics.
Mike Shortall
1:29 am on Sunday, March 10, 2013
If the Federal government will set up and take responsibility for running the insurance exchanges, and the Medicaid expansion is basically an under-funded mandate, since only 90% would be federally funded in the out years, what makes taking part in the exchanges and accepting the Medicaid expansion an economically sound decision?
Under-funded is just another way to push Federal responsibility down to the States without all the funding associated with the new responsibility.
Adrian Seltzer
2:57 pm on Monday, March 11, 2013
You too are ignoring #1. CHIP will be funded at a higher rate, there will be more mental health coverage and increased work force means higher tax collection, etc. These are things that will offset some of those expenses and go back to #1 if not.
Mike Shortall
7:36 pm on Monday, March 11, 2013
No person, group, or government entity ever "opts out" once they're on a Government dole.
Adrian Seltzer
8:32 pm on Monday, March 11, 2013
Why won't they if the option is there? Whose fault is that? Certainly not the under insured. Maybe it is the clowns we keep electing (from both paties) who are beholding to big money interests. Mike we both have to run for office.
Mike Shortall
9:42 pm on Monday, March 11, 2013
I don't have the temperament ... or the money.
Richard Weisgrau
11:55 pm on Monday, March 11, 2013
I just don't see how opting out is good a good solution. @Mike asked: "what makes taking part in the exchanges and accepting the Medicaid expansion an economically sound decision?"
My answer is that without the expansion, those in need of medical care will do what they have been doing for decades – going to the emergency room instead of a Doc's office, and that costs ten to 20 x what an office visit costs. The bill never gets paid, and the cost is added into hospital costs and then passed onto us in the from of higher medical fees, higher insurance premiums, and higher taxes. Those items are a bigger drag on the economy that Obamacare will ever be since it will at least get the needy out of the highest cost avenue of care (the ER) for routine care. Am I wrong? Convince me!
Mike Shortall
8:05 pm on Tuesday, March 12, 2013
Richard: My comment went to what makes it a sound economic decision for THE STATE? If the Federal government wants to expand Medicare, go for it, assuming you can pay for it.
My opinion is that it would be a stupid decision for Pennsylvania to take on expanded Medicare when you KNOW going in that in several years the Fed will be cutting the State Medicare subsidy by 10%.
Adrian Seltzer
9:00 pm on Tuesday, March 12, 2013
Even with the added jobs and economic stimulus? Isn't it better than a block grant which will fall way short of covering the people who are currently on Medicaid.
Mike Shortall
9:20 pm on Tuesday, March 12, 2013
You're going to have to quantify that for me. How many jobs? Economic stimulus in what way? How much? What will the Administrative costs be to the State? How big a bogey is that 10% shortfall in Federal funding after the first year(s)?
Frankly, I can't imagine the State wouldn't have looked at that before rejecting the offer. That would only make sense.
I know Christie accepted the expanded Medicare offer because - for one reason - the savings provided, but only for the first year. There was no discussion that I saw that looked at the out-year costs vs. benefits.
Adrian Seltzer
11:45 pm on Tuesday, March 12, 2013
Estimates for jobs are 41,200, and there is 100% reimbursement for the first three years. The state in its budget projections of sale of state store didn't take into consideration the profit made by the state stores that they will be losing, so I can imagine the state not looking at that.