- Associated Press - Monday, March 24, 2014

HARRISBURG, Pa. (AP) - Democrats in the running to take over Republican Gov. Tom Corbett’s job next year say they would throw out his alternative plan for using federal Medicaid expansion dollars in favor of a straightforward expansion of the state-federal health insurance program.

Pennsylvania’s state Treasurer Rob McCord on Monday called Corbett’s plan “boneheaded from beginning to end.”

Medicaid coverage, he suggested, is more cost-effective than the private insurance market that Corbett’s alternative plan would tap.

“People who live quarter to quarter on profits have a very different modality than those who say we’re here primarily to help poor people with predictable challenges,” McCord told a Pennsylvania Press Club luncheon in Harrisburg. “So when you’re trying to drive down the hospitalization rates of people who are struggling with diabetes, Medicaid is the best, not the worst, at providing that kind of service.”

Still, McCord acknowledged that pulling the plug on Corbett’s plan in favor of a Medicaid expansion could be complicated and present bureaucratic hurdles.

“You just don’t know until you get there,” McCord told reporters after the luncheon.

The other Democrats vying for the party’s nomination to take on Corbett in the Nov. 4 election - former Clinton White House adviser Katie McGinty, U.S. Rep. Allyson Schwartz, former state Auditor General Jack Wagner and businessman Tom Wolf - also say they would scrap Corbett’s “Healthy PA” plan.

Democrats’ biggest objection to Corbett’s approach is that, because the federal Medicaid expansion dollars became available to states Jan. 1, billions of federal health care dollars aren’t flowing into Pennsylvania’s economy and low-income Pennsylvanians are missing out on health care.

Corbett hopes to have his plan take effect Jan. 1, about two weeks before the next four-year gubernatorial term begins. His administration defends the proposal as a Pennsylvania-specific solution to health care, rather than a “one-size-fits-all” Medicaid expansion envisioned under the federal law.

Because Corbett is seeking a long list of changes to the Medicaid program, he must get federal approval. That review officially began earlier this month, and it is possible the U.S. Centers for Medicare and Medicaid Services will approve parts, reject parts or insist on changes. It is currently subject to a public comment period through April 10.

The primary election is May 20.

Pennsylvania’s traditional Medicaid coverage is already channeled through private insurers, unlike some other states.

Under Corbett’s Medicaid alternative plan, newly eligible, low-income adults could buy subsidized private insurance policies that would be subject to marketplace rules that are different than Medicaid coverage.

That could mean narrower provider networks, fewer benefits and no retroactive reimbursement for someone who is eligible, but is not covered when they seek care, said Joan Alker, executive director of Georgetown University’s Center for Children and Families, who has closely followed states’ Medicaid expansion plans.

The jury is still out on whether private insurance can provide coverage for the same cost as Medicaid, Alker said. Private insurance historically is more costly, in part because it pays higher reimbursements to doctors and hospitals.

Twenty-five states, including three that already won approval from the Obama administration for alternative plans, are expanding Medicaid-funded health insurance under the 2010 law.

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