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Pa. official, in D.C., takes heat on Medicaid

WASHINGTON - For Gary Alexander, a trip to Capitol Hill on Thursday was full of confrontation.

WASHINGTON - For Gary Alexander, a trip to Capitol Hill on Thursday was full of confrontation.

Alexander, the Corbett administration official who oversees Medicaid, was at the center of several charged exchanges as he criticized President Obama's health-care law, faced sharp questions from a congresswoman about children dropped from Pennsylvania's Medicaid rolls, and answered a reporter's inquiries about his use of a state car to commute between Harrisburg and Rhode Island.

Alexander, Pennsylvania's welfare secretary, was called to Washington to testify on one of the most divisive issues in the country, the Affordable Care Act, one day after Corbett announced Pennsylvania would not open its own health-care exchange, a key piece of the law.

"We in the commonwealth have never witnessed a law so vast, with such demands on state resources, and lack of federal guidance," Alexander told the House Energy and Commerce Committee's subcommittee on health. He cited "hundreds" of federal mandates that he said will demand man-hours and increase costs. He said it amounts to federal "micromanaging."

The hearing was ostensibly centered on Obama's plan to allow states to expand Medicaid eligibility, with the federal government picking up all of the coverage costs to start, and 90 percent of the tab from 2020 forward. Democrats say the plan will help states provide health coverage to huge swaths of the uninsured populace with relatively few direct costs.

Corbett has said the expansion would still be expensive in the end. Alexander echoed that concern, but said the administration had not ruled out a Medicaid expansion.

"Ten percent of a huge number is still a very large number," he told the committee. Given persistent federal deficits, he questioned whether Washington would keep its promise to pay the bulk of the cost.

Expanding Medicaid under the new law would cost Pennsylvania an additional $2 billion through 2022 and help some 542,000 new Pennsylvanians enroll, according to a study by the nonpartisan Kaiser Foundation on Medicaid and the Uninsured.

Corbett's administration puts the cost at $4 billion.

To Democrats, Medicaid expansion would be a good deal for states, bringing an infusion of federal dollars and helping more low-income individuals and families get health coverage. The federal government would pay an additional $37.8 billion over the next decade to help cover Pennsylvanians, according to Kaiser.

"It simply is immoral to allow our fellow Americans to suffer because they can't access health insurance," said U.S. Rep. Frank Pallone (D., N.J.), the top Democrat on the subcommittee.

He accused Republicans of stalling on the Medicaid expansion and health exchanges as part of their latest attempt to stymie the law.

So far, 17 governors have committed to expanding Medicaid.

Alexander was joined by counterparts from Louisiana and Wisconsin, states also governed by Republicans, in blasting the law and its costs.

Officials from the Obama administration, Maryland and Arkansas, meanwhile, praised the Medicaid expansion and the help it offers people with no health coverage.

"Basic services and basic health care shouldn't be considered excess," said Maryland Health Secretary Joshua Sharfstein. His state is projected to save nearly $2 billion because of the Medicaid expansion.

U.S. Rep. Jan Schakowski (D., Ill.) seized on Pennsylvania's controversial review that dropped 89,000 children off Medicaid between August 2011 and January.

"I think that's a fraud to do that to children," Schakowski said.

Alexander said the review was part of making sure only those who are eligible for Medicaid were enrolled. Those removed from the Medicaid rolls were allowed to reapply.

"We're here to serve the truly needy and eligible families," he said.

Alexander's public appearance came one day after a report from the Pennsylvania Independent, a Harrisburg online news service dedicated to public interest journalism, that said he drives a state-owned car from Harrisburg to his home in Rhode Island dozens of times a year, raising questions about the costs to taxpayers and his presence in the state capital.

"My family lives in Rhode Island, I have two small children and a wife I love very much," Alexander said when asked about the report. "I also pay for part of that vehicle. It comes out of my check and I've been allowed to use it to go back and forth."

A welfare department spokeswoman said he pays $11,000 a year in federal taxes for using the car. Alexander also said he has worked to cut down spending in his department.