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CPBJ Extra Blog

Count me with the skeptics

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Count me with the skeptics.

Gov. Tom Corbett has been wrangling with the U.S. Department of Health and Human Services for a while now, and what does he have to show for it?

Looking at the Pennsylvania Insurance Department's Federal Health Care Reform page, I'd say "sore fingers" is a fair answer. The thing is a graveyard of lost causes. Corbett has wanted to go a different way than HHS on numerous health care reform issues, and unless I'm missing something, he has not won the day on any of them.

(Also, what do you think are the odds that all the letters to HHS say something about insufficient guidance or information to make a decision? High, I'd say.)

That being the case, why should his Healthy Pennsylvania proposal fare any differently? You may mention that both Arkansas and Iowa have advanced plans with a similar expanding-private-insurance-with-Medicaid-money framework, but I will merely quote the rest of the sentence to you, "neither of which has been approved by the federal government."

Then let us consider the part of the proposal unique to Pennsylvania: Job training and job search requirements for all working-age Medicaid beneficiaries. Do you think HHS will grasp eagerly at that suggestion? I don't. And I have similar expectations on the part about what Corbett calls "instituting a modest monthly premium."

Note that I am not venturing any opinion on whether these plans would, in fact, work, just on the likelihood of their obtaining the necessary approval.

Medicaid may be a joint state and federal affair, but there's a distinct power differential there, and Corbett is on the wrong side of it. He could convince you, me, and all of Pennsylvania if he wants, but unless he gets the federal nod and the federal dollars, it's no go. And if you consider that the feds have generally viewed Medicaid as it currently exists as the answer, and that this proposal rather casts it as a problem — well, to me that makes approval look unlikely.

What do you think?

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