No cure for health care cynicism

Offered an opportunity for simple and inexpensive health care coverage for many thousands of low-income working Pennsylvanians, Gov. Tom Corbett instead has chosen political coverage for himself.

Well, politically and practically, the governor is in a tough spot. To rally the hard-right wing of his Republican Party for his shaky re-election prospects, he can't just accept the abundant benefits offered to the commonwealth by that wing's favorite bogeyman, "Obamacare." At the same time, it's horrendous governance and, therefore, bad politics in its own right, to walk away from expanded health care coverage that not only creates health care access for thousands, but ensures that health care providers will be paid for the costs of billions of dollars' worth of care that they otherwise have to swallow.

Mr. Corbett came into office as a plaintiff in the failed lawsuit claiming that the federal Affordable Care Act was unconstitutional. And he further cemented his bona fides against expansion of health coverage to low-income workers by making cancellation of the adultBasic health care program one of his first acts as governor.

A principal device of the Affordable Care Act to expand insurance coverage is to enroll millions of low-income workers in the state-federal Medicaid program. Those people work but do not have coverage through their employers, and don't earn enough to buy coverage. Under the law, the federal government would cover 100 percent of the cost for three years, after which the state would have to pick up just 10 percent each year.

The Supreme Court upheld the law but ruled that states may choose whether to participate in the Medicaid expansion. Doing so should be a no-brainer because it's such a good deal.

Mr. Corbett, however, has concocted a complex hybrid plan that would funnel billions of dollars to private insurers instead of enrolling the new participants directly in Medicaid, which could provide the coverage at less cost.

Federal regulators would have to approve that. And the governor included a poison pill - requiring Medicaid applicants to show that they actively are seeking work. Most of the prospective new enrollees work, which is why they don't qualify for Medicaid in the first place. And the feds already have rejected the work requirement for Medicaid in two other states. If they reject the Corbett plan, the governor will blame the lack of expanded coverage on the feds.

The governor has advised the Legislature that it's an all-or-nothing proposal that does not require its approval. Lawmakers who care more about public health than politics should disabuse him of that notion and enact simple, apolitical, low-cost Medicaid expansion.

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No cure for health care cynicism

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