Health Care Advocates and Politicians Discuss Obamacare Savings in Philly


On Thursday afternoon, State Senator Vincent Hughes (D-Philadelphia) held a roundtable discussion on the potential benefits of expanding Medicaid in Pennsylvania. He was joined by a who’s-who of health-care and policy types from around the state, including the Senate Democratic Appropriations Committee, Philadelphia Health Commissioner Donald Schwarz, Sharon Ward of the Pennsylvania Budget and Policy Center and about 15 others who came and went throughout the two-hour meeting on City Hall’s second floor.

Hughes said he held the meeting, in part, to showcase the savings that the Patient Protection and Affordable Care Act (a.k.a. Obamacare) will bring Pennsylvania — as well as the massive amount of federal money we’ll be getting. Among those, he said: a $4 billion infusion into Pennsyvania’s annual budget; an estimated 285,000 new jobs over the next 10 years; and the unburdening of hospitals of $1 billion in uncompensated care costs.

Gov. Corbett has opposed key elements of the PPACA to date, citing concerns over its cost. “After you get through the fight of successfully winning the legislation, you’ve got to deal with the issue of implementation,” Hughes said. “Implementation is largely left up to the states, and it was clear the governor was not going in this direction.”

As we’ve explained in the past, part of the Supreme Court’s 2012 decision to uphold the PPACA involved allowing the individual state governments to decide whether to accept its provision that would expand Medicaid eligibility for low-income Americans. Currently, Medicaid is a government health insurance option available only to those below the poverty rate, which is about $11,000 annual income. The expansion would allow those making 133 percent of the federal poverty rate ($15,302 per year for one person; $31,155 for a family of four) to apply for Medicaid. Several states have already accepted the expansion — including even Arizona, whose governor, Jan Brewer, is a well-known Obama foe — while others, like Texas, have not. The terms of the expansion are: The federal government would pay 100 percent of the costs for the first three years, then 90 percent thereafter.

Advocates on today’s panel did their damnedest to explain that this is something the state needs not just for its poor, but for hospitals, whose federal reimbursement payments for care to the uninsured are set to expire in 2014 when the whole of the PPACA goes into effect. Here are some highlights from those who spoke:

  • Philadelphia Health Commissioner Don Schwarz noted that the city itself owns and operates eight of the 32 health centers in town— and of the patients they see at those eight, 52 percent do not have health insurance.
  • Robin Rudowitz, associate director at the Kaiser Commission on Medicaid and the Uninsured, discussed a Kaiser Commission report on the Medicaid expansion, which estimated that there are approximately 500,000 Pennsylvanians currently without insurance who would qualify for Medicaid under the new rules.
  • Dr. Arthur Evans of the Philadelphia Behavior Health Department noted that after Governor Corbett’s 10-percent cut to mental health services in Pennsylvania, federal dollars are needed to combat the damage now being suffered by those who need (and provide) mental health care.
  • U.S. Rep. Allyson Schwartz noted that the way the PPACA is written, it’s designed to be a public-private partnership as well as a federal-state partnership — and that Gov. Corbett’s recent decision to reject a state-run health care exchange (and the federal funds that would accompany it) in favor of leaving such services entirely in the hands of the federal government is both a “disappointment” and a “lost opportunity.”
  • Sharon Ward of the Pennsylvania Budget and Policy Center noted that while it’s good the PPACA allows 26-year-olds to stay on their parents’ health plans, some parents don’t have health plans for which their kids to latch onto into adulthood. And what about them?

If any one thing could be taken from the meeting, though, it’s that the progressive counterpoint to the Republican talking point that health care will cost too much is to discuss the savings — which, it was noted, Republicans too often leave out of their estimates. More health care, studies show, often means more preventative health care, which saves everyone money in the long run. Between the long-term savings of health-care reform and the reduction in emergency-room visits that are never paid for, it was argued, health care reform should pay for itself — and when the federal government offers your state free money for its neediest individuals, well, you take it.

“We still have an ideology fight,” said Hughes. “We won it in the national election. The far-right Tea Party guys don’t want anything from the federal government. They don’t want, from their perspective, intrusion. And here you have a situation where folks are saying, look, we will pay for the insurance of maybe three-quarters of a million people in the Commonwealth of Pennsylvania. How do you ignore that deal? I bet you if someone walked up to them, individually, and said here’s cash, will you take it? They would take it.”

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