Over the recent budget season, Republican Gov. Tom Corbett showed he’s willing to be the guy who kicked thousands of vulnerable people — victims of domestic violence, children in the care of non-relatives — off government assistance. But a national reputation for illegally throwing tens of thousands of children off Medicaid? That just might be too far.
That’s why, while some conservative governors like Texas Gov. Rick Perry are taking a stand against the expanded version of Medicaid created by the Affordable Care Act (ACA), there’s a possibility that Corbett may quietly acquiesce.
The same U.S. Supreme Court ruling that supported Obamacare’s controversial individual mandate to buy health insurance made it easier for states to opt out of the law’s Medicaid expansion, which is set to provide health insurance to a huge chunk of currently ineligible poor people — up to 682,880 Pennsylvanians — living below 133 percent of the federal poverty line.
“There is no decision on that, and we are still reviewing the law,” says Department of Public Welfare spokesperson Donna Morgan.
Pennsylvania’s governor does have a solid track record of cutting health care for the poor, eliminating the adultBasic program covering 40,000 poor Pennsylvanians who weren’t quite poor enough to qualify for Medicaid and introducing a cumbersome new application procedure for the state’s Medical Assistance program.
Then there are the thousands of people the state kicked off Medicaid: The state’s initial figures recorded 130,000 people, including 89,000 children, between August 2011 and January 2012. They later reduced the total to 56,000. A directive from Harrisburg, welfare workers say, required them to review a backlog of documents in a matter of weeks and created a bureaucratic mess that led to coverage being improperly cut. A new federal investigation backs up worker claims.
The federal Centers for Medicare and Medicaid Services, in a June 14 letter first reported by the Associated Press and since obtained by City Paper, requested more information from the Corbett administration to determine whether “federal guidance and state procedures” may have been violated.
“A large number of cases,” the letter noted, “were closed for ‘failure to provide information’ or ‘failure to return renewal form’ at a time when DPW has reported that it was unable to process within appropriate time frames all the information beneficiaries had submitted to verify their eligibility.” The letter cites an August 2011 state audit that discovered a major backlog at one County Assistance Office, where information verifying individuals’ Medicaid eligibility was not “scanned into the system and electronically linked” to the respective individuals’ files.
The Corbett administration seems acutely spooked by accusations it illegally threw thousands of children off Medicaid.
Any decision to block Obamacare’s Medicaid expansion will undoubtedly rekindle criticism of the governor’s record. Could this push a cautious Corbett to buck the right-wing national winds and accept the expansion?
“That’s the million-dollar question,” says Community Legal Services staff attorney Kristen Dama. “He didn’t come out like a lot of conservative governors did and issue a knee-jerk reaction to the ACA ruling and say, ‘We’re not going to expand Medicaid.’”
Hospitals in Pennsylvania, like in states nationwide, are certain to exert heavy — and perhaps decisive — political pressure to push Corbett to sign on. They are counting on the increased Medicaid coverage to counter the law’s sharp cuts in reimbursements for care provided to the poor and uninsured. But Corbett’s particularly ugly record on Medicaid, and the potential violation of federal law, could make him eager to accommodate Obamacare and steer clear of TV cameras. “Corbett will feel significant pressure on the Medicaid front because of his past decisions on that matter,” says Muhlenberg College political-science professor Christopher Borick.