Will Corbett’s ‘Medicaid-like’ expansion require work searches for the employed?

Come view my Modest Proposal.

Come view my Modest Proposal.

So, it’s come to this. Gov. Tom Corbett’s strategy of quiet spite is finally leading to the place it’s supposed to be: Anonymous sources feeling out their own rumors released to the media.

After a year of non-answers on Medicaid expansion—then a truly terrible episode in which the Patient Protection and Affordable Care Act provision was inserted into the state Welfare Code only to be taken out last spring—the governor’s people are now anonymously telling the Capitol media that their boss may be willing to accept a ‘Medicaid-like’ expansion for the state’s poor and working class.

According to Lancaster Online:

One source said the governor’s proposal will look much different than the plan put forth by the Obama administration. Instead of expanding Medicaid, the state would set up a health insurance system that would offer coverage from private companies.

Ah yes, privatization and personal responsibility! Exactly what those earning minimum wage need more of! That’s explained a bit more in the Inquirer, which gets more specific about what other requirements in Corbett’s plan may be.

Corbett has made clear that he wants to change Medicaid. In recent statements, however, Beverly Mackereth, secretary of the Department of Public Welfare, was more specific about what “personal responsibility” might look like. There might be a “work-search” requirement, for example, and co-pays for emergency-room visits.

Without on-the-record details, it’s hard to tell exactly what this may look like for Pennsylvanians. But as long as rumors are mongering, let us monger, too!

The common statistic surrounding this issue is that at least half-a-million Pennsylvanians would become insured if the state were to accept the Medicaid expansion, as defined within the confines of Obamacare.

Of those without healthcare, the Philadelphia Health Management Corporation has estimated that about 137,000 of those adults live in Philadelphia. Some coverage expansion plans under Obamacare required by all states—like the one that allows children to keep their parents’ health care coverage until they’re 26—don’t take into account those kids whose parents have no healthcare.

The Medicaid expansion, which was deemed optional by the states, would help end that. As I wrote yesterday: “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.”

But here’s the kicker. As noted by Keystone Politics, some so-called ‘cost-saving’ measures of a ‘Medicaid-like’ expansion would actually see poor patients spending more money on their emergency room visits, through a broadly-defined “emergency room co-pay” for people who, since they have health care, no longer need to go to the emergency room for their hospital visits.

And about that “work search” requirement?

It, too, has not been detailed, yet, though Corbett did discuss one envision of it while on the Dom Giordano show. But assuming it means those qualifying for the expansion would also be required to search for work during a specified amount of time, it’s just about the worst idea we’ve heard in this debate.

Not just because it’d be a waste of time, but because it would misread the entire situation as a whole.

Those who would qualify for Medicaid under the expansion plan already work. They just make bad money, in part because the state’s minimum wage is still at the federally-required minimum.

Some people who currently receive Medicaid do not work. Sure. But the point of the expansion is to insure people who do. They just don’t make enough money to buy private health care and make too much to currently qualify for Medicaid as is. Monitoring a work search (assuming that’s what’s meant here, which we’re assuming since the governor’s people are talking about tying the idea to the Medicaid expansion)  will add an unnecessary level of bureaucracy onto the state Medicaid system and waste everyone’s time all in the name of appeasing the governor’s quickly-dwindling base.

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