Pileggi also acknowledged Christie's decision, along with that of other Republican governors in other heavily populated states — Florida, Michigan and Ohio — who support the expansion.
"I think it's very relevant that those governors have made the decision they've made," Pileggi said. "It shifts the argument to why is Pennsylvania situated differently and were there different considerations in those states that led to a decision that would not make sense in Pennsylvania."
Corbett and his top aides have listed a number of reasons not to join the expansion. At the top of Corbett's list is his insistence that the state have flexibility to shape Medicaid's coverage plans for different populations, a concept that the federal government has said for months that it is making available to states.
Hughes, during an Appropriations Committee hearing Tuesday, tried to reiterate that point to Corbett's top Health Department officials. U.S. Health and Human Services Secretary Kathleen Sebelius told him in a meeting last week that the Corbett administration has been told that the flexibility it wants is available, Hughes said.
The federal government offers a major incentive for states to join: It is promising to pay the full cost of the expansion for three years, after which the subsidy gradually shrinks to 90 percent of the cost. The money begins flowing Jan. 1. Along with other elements of the federal health care law, it is estimated that it would cover more than half of the 1.3 million people in Pennsylvania thought to be without insurance.
Uninsured adults would primarily benefit. For instance, the expansion would cover parents in a family of three earning up to $26,344 a year, up from the current income eligibility limit of $4,391, according to the Pennsylvania Health Law Project. Subsidized coverage is already more liberal for children.