New fight for Pennsylvania Medicaid expansion continues in Philly City Hall

photo(143)With the Legislature set to re-convene on September 23rd, several advocates from Philadelphia and beyond are revamping their fight to bring the Medicaid expansion of the Patient Protection and Affordable Care Act to Pennsylvania.

They met in the caucus room of City Hall on Tuesday to figure out a way to bring medical care to those Pennsylvanians who make too much money for Medicaid’s current requirements, and not enough to buy private healthcare. Specifically, they sought to figure out what, if any, progress has been made since the spring; and as a means to catch up on the important law, which we’ll also do here.

The expansion itself, as PW has written numerous times before, was deemed by the the single optional portion of Obamacare by the U.S. Supreme Court. Left up to the states, the Medicaid expansion would create a larger pool of Americans who qualify for Medicare, a government-run health insurance option for the poor. Under the Obamacare provision, working people who make up to 133 percent of the poverty level would be insured. That means individuals making $15,400 and families of four bringing in $31,800.

To put that in perspective, an individual working full time and earning minimum wage would qualify for Medicaid under the expansion, since the $7.25 minimum wage earns one $15,040 per year before taxes. Currently, minimum wage full-time workers cannot get benefits through Medicaid. If the state were to, say, raise the minimum wage, those workers would have to pay for their own health care through the state exchanges that’ll be set up in 2014.

Several governors, both Republicans and Democrats, have decided to accept the expansion for their own states—which the federal government will largely pay for out of money that was once spent on Disproportionate Share Payments (federal money sent to hospitals to make up for those patients who do not have health care and cannot afford to pay.)

The meeting to discuss all of this was held in the City Hall caucus room on Tuesday, and was attended by State Sen. Vincent Hughes, state Rep. DiGirolamo, John Dodds of the Philadelphia Unemployment Project, Morgan Lindsey of SEIU Healthcare PA, and several others.

While there, organizers and community leaders spoke of making calls for the law over the summer. They also discussed other options than full expansion that’ve been put forth by other states. There was a slight recap of last spring’s movements over the bill, too.

About that: State Sen. Hughes had been leading the fight for the expansion for half the year, introducing a bill that would make the Legislature go on the record about expanding health coverage hadn’t gone anywhere. When that didn’t work, he had attempted a legislative tactics to force a vote on the law, though by the end of the session, nothing had seemed to poke through.

Until June’s 11th hour. As the state budget’s feet began creeping its way toward Gov. Corbett’s desk, getting ink-stained along the way, Hughes managed to get his Medicaid expansion legislation through committee and the senate, written into the state Welfare Code. The House Rules Committee then eliminated the language from the bill, sent that to the full House, where it was voted up, then sent that same bill back to the senate, where they too were apparently OK with it, and gave it a majority vote.

“I’m deeply disappointed that House Republicans voted to remove the Medicaid expansion language from House Bill 1075. Expanding Medicaid would provide health insurance to 500,000 low-income working adults in Pennsylvania. These are the people who clean our buildings, serve our food, care for our seniors, and work other low wage jobs,” Hughes said at the time.

And that’s sort of how it ended.

This week, state reporters say there’s been a small glimmer of hope in the Capitol as Corbett Administration officials quietly spend the week meeting with state legislators about options for expansion. One Republican maneuver in other states has been to expand Medicaid in a semi-private healthcare manner, as was done in Arkansas and Iowa.

Those options were discussed at Tuesday’s meeting in City Hall, and not entirely cast aside. Public Welfare Secretary Beverly Mackereth recently noted the administration had been studying the law to see if there was anything that could be done in Pennsylvania. The writing on the wall says this is a good, responsible idea, but it may be hard for a Republican governor to go along with anything that has Obama’s name on it—let alone his signature piece of legislation.

Follow Randy on Twitter: @RandyLoBasso

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