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Pennsylvania Gov. Tom Corbett

State reform update: Pa. governor latest to seek Medicaid changes

By Rich Daly
Posted: April 2, 2013 - 4:00 pm ET

Governors continue to make pilgrimages to HHS as states keep trying to craft custom versions of the healthcare reform law's Medicaid expansion and avoid leaving new federal funding on the table.

Pennsylvania Gov. Tom Corbett planned to meet with HHS Secretary Kathleen Sebelius Tuesday evening to explore his state's options, according to spokeswoman for the governor.

Corbett, a Republican, told the Pennsylvania Legislature in February that he opposed raising Medicaid eligibility but has since signaled he might support growing the program using a tailored approach.

A March 28 RAND Corp. study concluded that expanding Medicaid in Pennsylvania under the Patient Protection and Affordable Care Act would provide Pennsylvania another $2 billion a year and extend coverage to 340,000 more residents.

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The state's hospitals and others pushing Corbett to change course are watching closely.

“Medicaid expansion would provide substantial benefit to the physical and fiscal health of Pennsylvanians, the commonwealth and its hospitals,” said Roger Baumgarten, a spokesman for the Hospital and Healthsystem Association of Pennsylvania. “We hope that Gov. Corbett emerged from his meeting with more questions answered.”

Here are some recent developments in other states:

Democratic Arkansas Gov. Mike Beebe, whose tailored Medicaid proposal fueled the push by many states to look for special dispensation, received a letter from Sebelius April 1 that appeared generally supportive of his plan.

Few details have emerged about the Beebe plan, which would use the new federal funding to buy private health insurance for low-income residents through the federal health insurance exchange beginning in 2014.

Arkansas' suggestion is "generally consistent" with goals to expand health insurance coverage, Sebelius said in the letter. Federal officials assured the governor that they would work with the state to implement it.

State legislators were expected to unveil legislation Tuesday that would carry out the Medicaid expansion, according to a Beebe spokesman. It will need strong support from Republicans, because they control the state Legislature and spending bills require support from three-fourths of members.

Time could become another challenge for the governor. The legislative session ends in three weeks.

Indiana lawmakers are considering legislation that would expand Medicaid through a state-run program. The House Public Health Committee approved that measure Monday, the Associated Press reported. The plan retains an opt-out provision for the state in case federal funding is cut in future years.

The vote revealed splits among Indiana Republicans because it removed a major part of a proposal in the state Senate that was supported by Republican Gov. Mike Pence. The House bill would use standard Medicaid funding from the federal government. But Pence preferred federal block grants, which are more restrictive but would give the governor more control over how the Medicaid expansion is implemented.

Pence is awaiting CMS approval of his request for a Medicaid block grant to expand the Healthy Indiana Plan, which would be the vehicle for the coverage.

The Missouri General Assembly has votes slated later this week on Medicaid legislation, and there's no sign that the governor and legislators are close to agreeing on what course to take.

The Missouri House passed a state budget on March 28 without the Medicaid expansion that Democratic Gov. Jay Nixon wants, according to the St. Louis Post-Dispatch.

However, the budget now goes to the Senate and the two chambers are expected to produce a final document by early May.

A bill started to advance through the House that would implement many Medicaid changes requiring waivers from the federal government. Those changes include a shift to private managed-care systems, a push toward preventive care and the addition of financial incentives for recipients to keep their healthcare costs low.

Meanwhile, Nixon has continued a weekslong tour across the state rallying support for the Medicaid expansion. In a recent statement he pledged to “continuing to work with the General Assembly to make our health system as efficient and effective as possible by bringing the tax dollars Missourians send to Washington back to work here in Missouri.”

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