Pennyslvania's Gov. Tom Corbett spent a year negotiating a deal that will allow the state to expand Medicaid eligibility on its own terms.
But Corbett's deal, which differs in some key ways from the Medicaid expansion originally envisioned under the Affordable Care Act, could be scrapped soon after it is set to take effect. And that would be just fine for Obamacare advocates, since, either way, hundreds of thousands of Pennsylvanians will end up being eligible for health coverage that they previously couldn't get.
The odd situation is the result of the ongoing governor's race in which Democratic challenger Tom Wolf is looking to unseat Republican Corbett. Both favor Medicaid expansion—but Wolf is saying Corbett's way of doing it might not be the right way.
Last week, Corbett announced that the federal government had agreed with his plan to expand Medicaid eligibility in Pennsylvania to include nearly all poor adults, including those without children. His announcement came on the heels of a new campaign poll showing Wolf leading by about 25 percentage points.
Corbett's plan included details that were different than so-called straight Medicaid expansion. While federal money will be used to buy health coverage for newly eligible adults—as many as 600,000—it will be done through the private insurance market in a managed care program.
And while Corbett failed in his bid to have enrollees be obligated to be employed, he did manage to get the federal Centers for Medicare and Medicaid Services to agree to require those who earn more than $11,670 annually to start paying premiums for their coverage beginning in 2016. Medicaid enrollees typically aren't required to pay premiums. Under the state's plan, the premiums can be reduced if an enrollee agrees to change certain behaviors and work.
"From the beginning, I said we needed a plan that was created in Pennsylvania for Pennsylvania," Corbett said last week.
Much of the coverage of Corbett's announcement focused on the fact that Pennsylvania was the 27th state, along with the District of Columbia, to endorse the major Obamacare provision to expand Medicaid coverage for low-income adults who had previously been ineligible for the joint state-federal program because of income caps or parenthood conditions. The federal government will foot the entire cost of insurance for the newly eligible through 2016, and then its share will decrease over time to 90 percent.