HARRISBURG, Pa. (AP) - Gov. Tom Corbett said Wednesday that he is getting to his “breaking point” over the Obama administration’s apparent resistance to his plan to use billions of federal Medicaid expansion dollars to subsidize private health insurance policies.
Corbett’s plan requests more expansive changes to the Medicaid expansion than any other state has sought. The 2010 federal health care law envisioned the expansion as a way to insure many more Americans, including hundreds of thousands of working poor in Pennsylvania.
But the federal government has apparently begun to resist more than one element of Corbett’s bid to use the taxpayer money to expand the private health insurance market rather than the government program.
Administration officials say they believe federal officials are backtracking on the encouragement they had given in private conversations over the past year to the changes Corbett sought.
“Frankly, I’m starting to feel like a yo-yo,” Corbett told reporters after addressing a conference of health care professionals organized by the state Department of Health at the Farm Show Complex and Expo Center in Harrisburg.
Corbett would not get into specifics about which elements of his plan are creating resistance, and neither would his secretary of public welfare, Beverly Mackereth.
But, Corbett said, “right now, the road is getting bumpier rather than smoother. … I am getting to my breaking point.”
Mackereth said the administration would learn more about the federal government’s position on his plan after April 10, the last day the federal government will accept public comment on it. That, said Mackereth, is when negotiations over the proposal will really begin.
At issue is a Monday conference call between staff members of the Corbett administration and the Centers for Medicare and Medicaid Services. Corbett administration officials say they received discouraging signals about elements of the plan, but would not say exactly what was said.
A spokesman for the U.S. Department of Health and Human Services did not respond to a request for comment Wednesday.
The changes sought by Corbett include waiving Medicaid’s rules on retroactive coverage, benefits and networks for the private insurance plans that would funded by expansion dollars. He is also seeking to overhaul the plans offered in the state’s traditional Medicaid program and to tighten limits on some of the benefits under those plans for healthy, working-age adults.
Corbett submitted the plan to the federal government Feb. 27, but after that, opposition from the Obama administration prompted him to ease one of the most controversial conditions, to require able-bodied, working-age Pennsylvanians to complete certain work-search activities as a condition of receiving Medicaid-funded health care coverage.
He instead asked U.S. Health and Human Services Secretary Kathleen Sebelius for a chance to institute what he called a voluntary, incentive-only one-year pilot program for able-bodied adults.
Advocates for the poor and uninsured had warned that no state has ever been allowed to tie Medicaid coverage to such a requirement and that the Corbett administration had been told for months that any work-search requirement would be rejected.
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 health care option under the law until then.
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