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As Corbett balks at expanding Medicaid, millions suffer

IN HIS BUDGET address Tuesday, Gov. Corbett is expected to highlight plans for corralling the staggering costs of state-employee pension obligations. In many ways, the pensions paid to some workers - particularly lawmakers - is a story of privilege and plenty. Lawmakers can collect their full pensions, averaging $35,000 a year, at age 50. (State employees wait until age 60, and theirs average $23,000 a year.)

These numbers are important to remember when looking at the flip side: the millions of families in the state who make far less in salaries than state employees make in pensions. That's why we're more interested in whether Corbett will finally decide to expand Medicaid - a key part of the Affordable Care Act.

There are two key components to the Affordable Care Act: First are the "health exchanges" that states set up to guide people toward options for low-cost health coverage. Already, Corbett has refused to have the state set up its own exchange, which leaves the job to the feds. The second component is an expansion of Medicaid, which provides health coverage to low-income people meeting certain requirements.

Two million Pennsylvanians are on Medicaid. The federal expansion would widen the eligibility to include people with incomes at 133 percent of the federal poverty level. The feds would pick up 100 percent of the costs of this expansion in the first years and 90 percent thereafter.

So why has Corbett, along with other GOP governors, refused the expansion, even though so much of the cost will be borne by others? Corbett claims that expanding Medicaid could actually cost the state money.

That's because he and other governors seem to think of low-income people without health coverage as something akin to termites: If you expand the program, lots of people who are eligible but not enrolled will "come out of the woodwork" and find out they could have had coverage all along. (This regular coverage of Medicaid is not reimbursed by the feds at the same level as the newly expanded model, so the costs would be higher.) It's actually referred to as the "woodwork effect."

So rather than urge people to see if they qualify for help, he'd rather let low-income families lie awake at night figuring out how they're going to help their sick children, or continue care for disabled or elderly relatives.

Keep in mind that Medicaid is primarily for working families who either don't get health care at work or can't afford it. Currently, a family of four that makes less than $11,525 is eligible.

Corbett has done the math on what that "woodwork effect" would cost. But it's clear he hasn't done the corresponding math on the price of refusing the expansion. Some of those costs were outlined in a hearing last week held by state Sen. Vincent Hughes. They include costs to hospitals, whose emergency rooms provide the primary health services for the uninsured, and the cost of illness that becomes more serious and expensive when left untreated.

Being sick - whether it's a cold or flu or a more-serious ailment - comes with the territory of being human. Apparently, in this state anyway, helping those who can't afford health care doesn't.