Top aide optimistic about Medicaid plan talks in Pa.

A top aide to Pennsylvania Gov. Tom Corbett said Friday that she is optimistic that negotiations will be productive on the Republican governor's plan to use billions of federal Medicaid expansion dollars to subsidize private health insurance policies for hundreds of thousands of Pennsylvanians.

The sentiment by Corbett's secretary of planning and policy, Jennifer Branstetter, was a turnaround from last week when Corbett had said he was getting to his "breaking point" over the Obama administration's apparent resistance to his plan.

Branstetter said she had received a call this week from an official from the CMS.

"I was encouraged by the call from CMS that these will be productive negotiations," Branstetter said.

She did not want to say who called or reveal what was said, since closed-door negotiations are expected to begin in the next week or two, now that the federal government's public comment period on Corbett's plan ended overnight Friday.

Community Legal Services, a Philadelphia public interest law center that advocates for the poor, did an analysis of the online comments received by CMS and said that 80% through midday Wednesday opposed Corbett's plan. Community Legal Services has been critical of Corbett's plan, too.

Corbett expressed his frustration last week after his staff said they had received discouraging signals about elements of the plan. Administration officials would not reveal exactly what was said, but they said they believed federal officials were backtracking on the encouragement they had given in private conversations over the past year to the changes Corbett sought.

A CMS spokeswoman did not respond to a request for comment Friday.

Corbett submitted the plan to the federal government in February, requesting broader changes to the Medicaid expansion than any other state has sought under the 2010 federal healthcare law.

Among the changes sought by Corbett include using the money to expand the commercial health insurance market instead of Medicaid coverage and waiving Medicaid's more permissive rules on when coverage kicks in. Accompanying Corbett's proposal is a request to pare the existing Medicaid program for healthy working-age adults, including limiting hospital admissions, medical supplies and radiology procedures such as MRIs, CT scans and X-rays.

The federal Medicaid expansion dollars became available to states Jan. 1. The Corbett administration has said that it would not be ready to administer a Medicaid-funded expansion of health insurance until 2015, and the Kaiser Family Foundation estimates that 281,000 low-income Pennsylvanians will be left without a healthcare option under the law until then.