Medicaid Expansion in PA – Understanding the Facts

By Rep. Gene DiGirolamo (R-Bucks), Chairman, House Human Services Committee

Nearly four decades ago when my wife and I first started our family, I was working 60-plus hours a week and struggling to pay for the basic necessities. When our first child was born, we didn’t have any type of health insurance. I will never forget that feeling of fear, hoping and praying that no one would get sick. This situation my family faced back then is the same situation facing hundreds of thousands of citizens of Pennsylvania right now.

A key provision of the Affordable Care Act (ACA) is expansion of eligibility for Medicaid benefits to individuals with incomes of about $15,000 and families of four with incomes of about $30,000. The federal government will pay for 100 percent of the cost of new enrollees for the first three years -- 2014, 2015 and 2016. After that, federal funds reduce gradually, until they remain at 90 percent, in 2020. Many, if not most, of the new enrollees will be working people with jobs that do not provide health care coverage.

According to estimates from Pennsylvania’s Independent Fiscal Office, the Medicaid Expansion will provide Pennsylvania with $17 billion to $19 billion in federal funds over five years or $34 billion to $38 billion over 10 years. This huge infusion of funding will lead to job growth in health care and related industries, increased tax revenues based on these federal dollars and will improve the health of working people who have no health care coverage. New enrollees will also be more likely to receive preventative care and seek help before expensive emergency treatments are needed. If not covered by this expansion, many of these working people will end up in hospital emergency rooms, which we will all pay for in some way.

New jobs, employees of small businesses gaining health care coverage, new tax revenues based on federal monies, improved health care for our citizens, savings on emergency treatment and putting our federal tax dollars to work here in the state – these are the benefits of the Medicaid Expansion.

Failure to opt into the Medicaid Expansion will also put our hospitals in jeopardy. Because of the ACA’s expansion of eligibility for Medicaid to thousands of new enrollees, hospitals accepted reductions in uncompensated care payments provided by the federal government.

Now, our neighborhood hospitals face both no expansion in Medicaid coverage for new enrollees and a simultaneous phasing out of disproportionate share payments for uncompensated care.

Like it or not, the Affordable Health Care Act is the law of the land. We have to make decisions that are the best for Pennsylvania. I perfectly understand Gov. Tom Corbett’s present position: That before deciding he wants to be sure Pennsylvania can pay its share after the first three years, and that we are allowed flexibility from the federal government to make that happen.

The Medicaid Expansion could potentially insure 700,000 people in Pennsylvania. As chairman of the House Human Services Committee, I am committed to working with the governor and the Legislature to find a way to make this work for our state.

The potential of $34 billion to $38 billion over 10 years of federal funds coming into our state is too good a deal not to make every conceivable effort to make it happen. If not, these critically needed billions will stay in Washington and go to other states. Let’s work together to get this Medicaid Expansion done.

Representative Gene DiGirolamo
18th District
Pennsylvania House of Representatives
Media Contact:  Jennifer Keaton
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