HARRISBURG, Pa. (AP) — Gov. Tom Corbett said Wednesday that he and U.S. Health and Human Services Secretary Kathleen Sebelius have agreed to meet to discuss issues surrounding an expansion of Medicaid that would potentially extend taxpayer-paid health care coverage to hundreds of thousands of low-income Pennsylvanians.
Corbett said he is still concerned about the cost of an expansion for Pennsylvania, and that the federal government cannot always be trusted to deliver on its funding promises to states.
"They promised to fund special education, as an example, a lot better than they do today," Corbett told reporters after appearing at an event in Harrisburg to recognize Black History Month.
He also said he was not convinced he should follow fellow Republicans like New Jersey Gov. Chris Christie and Florida Gov. Rick Scott who are supporting an expansion in their states.
"Each state has to look at it as to what it means and what they already provide," Corbett said. "For instance, a lot of states don't have what we have here in Pennsylvania with our (Children's Health Insurance) Program."
He also suggested that any expansion will need legislative approval as his administration works toward getting a budget approved for the fiscal year that begins July 1.
"We also have to determine where the funds are going to come from and how they're going to affect other programs," Corbett said. "That's why there's going to have to be discussions with legislative leaders as we work our way through the budget process."
Corbett spoke with Sebelius briefly while he was in Washington, D.C., earlier in the week for a National Governors Association meeting and they agreed to find a date to meet, he said.
Thus far, Corbett has declined to embrace the option of a Medicaid expansion, despite the federal government's offer to pay the lion's share of the cost. He has given a number of reasons why he will not pursue an expansion, at least for now, including the complaint that his aides still have many unanswered questions about the expansion.
A spokesman for Sebelius said Wednesday that the agency has been providing answers to the Corbett administration's questions and that they look forward to continuing the dialogue.
The Corbett administration projects a full expansion of subsidized health care, including a Medicaid expansion and the health insurance exchange, under President Barack Obama's sweeping 2010 health care law would cost Pennsylvania $4.1 billion over the next eight years.
But that estimate also includes costs that would be incurred anyway beginning next year because of the insurance exchange, regardless of whether Corbett embraces the Medicaid expansion.
The Kaiser Commission on Medicaid and the Uninsured projects a cost of $2.8 billion under just the Medicaid expansion for Pennsylvania over 10 years. Neither tally includes the full scope of what Democratic lawmakers say would be $670 million a year in state savings on current costs and increased tax collections that make the expansion a net tax benefit to Pennsylvania.
The Kaiser Commission estimates that 542,000 Pennsylvanians, primarily low-income working adults, would get insurance coverage under the Medicaid expansion. It estimates that another 178,000 who are already eligible for Medicaid would wind up getting coverage through the insurance exchanges.
One way Corbett's administration would want to control costs under an expansion is to have the ability to shape benefits for different classes of enrollees, rather than being forced to provide the same benefits package to everyone who is newly eligible under the Medicaid expansion. Federal officials say they are making that option available to states.
Corbett administration officials say Pennsylvania has one of the better Medicaid benefits packages in the nation. A comparison by the Washington, D.C.-based Medicaid and CHIP Payment Access Commission showed that Pennsylvania was in the top dozen states in 2009 in terms of spending per Medicaid enrollee.