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June 26, 2013

Republicans resist Medicaid expansion

HARRISBURG — With the days before the end of the budget discussions dwindling, efforts to expand Medicaid depend on how many Republican lawmakers break from their party.

A bid to push a bill calling for Medicaid expansion stalled Wednesday when the committee called by Rep. Gene DiGirolamo, R-Bucks, was abruptly canceled. DiGirolamo authored legislation calling for Medicaid expansion.

The bill has 78 co-sponsors, among them just three Republicans.

Republicans control the state House 110-93.

Rep. Bradley Roae, R-Crawford, is a member of the Human Services Committee that will consider the bill.

Roae said he would oppose the measure, but he believes it will be a close vote when it comes up.

“I anticipate all of the Democrats and some of the Republicans will vote for it,” Roae said. Republicans have a 15-10 edge in the committee.

Republicans in the Senate have indicated that they could vote on Medicaid expansion. The Republican leadership in the House has expressed no interest in the matter.

 “I do not anticipate (the Medicaid expansion bill) actually running on the House floor,” Roae said.

About 60 House Republicans turned out en masse to express their opposition to the expansion of Medicaid, a move that would provide government-issued health insurance to between 350,000 and 800,000 Pennsylvanians.

Matt Baker, R-Bradford, the chairman of the House Health Committee, led the gathering of Medicaid expansion opponents.

Baker said that Medicaid ought to be reformed, rather than expanded.

“We are already covering one out of every six people in Pennsylvania on state health insurance programs,” Roae said. “We will spend about 27 percent of the new fiscal year General Fund Budget on those programs.

Baker said that lawmakers in the state House were encouraged to refuse Medicaid expansion by three members of Congress – Rep. Joe Pitts, R-Greene, Rep. Keith Rothfus, R-Sewickley, and Rep. Tom Marino, R-Lycoming.

Marino said that adding the working poor to Medicaid will strain the system, making it difficult for people already enrolled to get the health care they need.

“This expansion would take a program that is already financially strapped and struggling to serve Pennsylvania’s most vulnerable citizens – children, the disabled, pregnant mothers – and exacerbate its flaws,” Marino said.

“The un-Affordable Care Act simply does not add up – state lawmakers and the governor would be foolish to double-down now,” Marino said.

Marino added that under Medicaid expansion, existing programs such as CHIP, which serves low-income children and teens, would be eliminated as their families are enrolled in Medicaid.

On Wednesday, Gov. Tom Corbett wrote a letter to Health and Human Services Secretary Kathleen Sebelius asking that Pennsylvania be allowed to retain CHIP if the states expand Medicaid.

Rep. Mauree Gingrich, R-Lebanon, said that there won’t be enough doctors to handle the influx of patients, forcing people to seek care in emergency rooms.

“This is the exact opposite of what expansion is supposed to do,” she said.

Gingrich’s comments contradict the findings in a study commissioned by the Hospital and Healthsystem Association of Pennsylvania. In that study, the Rand Corp. estimated that Medicaid expansion would lead to the creation of as many as 39,000 new jobs in Pennsylvania.

Roger Baumgarten, spokes-man for the hospital association, said most hospitals have begun preparing for the possibility of Medicaid expansion.

Baumgarten added that if Medicaid-enrolled patients showed up in the emergency room, it still would be better for the hospitals than having uninsured people show up in the ER.

“In addition, it is our expectation that greater numbers of Medicaid-covered individuals will result in more people seeking care in more appropriate settings (receiving primary care in primary care settings, rather than coming to costlier emergency departments),” Baumgarten said.

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