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No Shortage of Questions as Corbett Readies Medicaid Proposal

Sources within the Corbett administration say the governor will make an announcement about proposed changes to Medicaid Monday afternoon. It may take some time to answer questions about the fiscal prudence of the plan - and whether it can satisfy the federal government.

What's being proposed isn't an expansion, administration officials emphasize. They've hinted at a plan that would make reforms to Medicaid and use federal dollars to subsidize private health insurance for low-income Pennsylvanians.

It's a clever way to get the federal windfall so many want and still resist the Medicaid expansion that many others abhor.

Even if the plan bridges political divides, it may not bridge budget differentials.

"For this to work it needs to not cost more money," said David Grande, senior fellow at University of Pennsylvania's Leonard Davis Institute of Health Economics. "The reason that Medicaid is often relied upon as a primary way to cover low-income people is it's cheaper, and the reason it's cheaper is that it pays providers less money and there's no company that needs to turn a profit."

Department of Public Welfare Secretary Bev Mackereth has likened the proposal to those of Iowa and Arkansas, which have both submitted Medicaid reform plans to the federal government for review.

Whatever Corbett proposes will also need federal approval. Grande said if Corbett's reform plan includes additional cost-sharing with consumers or less comprehensive coverage, a green light isn't likely.

"Is it workable to buy private insurance? Maybe," said Sen. Pat Vance (R-Cumberland), a supporter of Medicaid expansion. "But will the feds go along with this if it's, like, half a loaf?"

"There are a lot of unanswered questions," Vance said. "Although, I think it's very positive that at least we're looking to provide more health care for Pennsylvanians."

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