THIS WEEK, the state launched enrollment for its new Medicaid program that provides health care for low-income people.

Before lamenting the downsides of "Healthy PA," we must applaud the fact that 600,000 Pennsylvanians who had fallen through bureaucratic cracks last year under the Affordable Care Act will now be able to have health-care coverage.

The newly eligible are primarily poor working adults, like home health-care workers, waitresses, construction workers and others who are raising families on low incomes and can't get coverage through their employer.

Reminder: This is the country we live in now, where too many low-wage workers can't afford to raise families, let alone afford "luxuries" like health care.

(Another reminder: If you have no health coverage, or are a current Medicaid recipient unsure of your status, call 1-800-692-7462 or go to

The newly expanded coverage is one of a number of changes coming to the state's Medicaid program. Those changes were prompted by Gov. Corbett's refusal to accept a federal expansion of Medicaid that was a major feature of the Affordable Care Act. The 23 states that did accept (primarily Democrat-run states) expanded their rolls so that more low-income people could get health coverage, with the feds picking up most of those costs.

One recent study found that hospitals in states that expanded Medicaid coverage saw a significant drop in uninsured patients - and improved earnings. States without expansion saw a rise in uninsured patients, and that means higher costs for all.

Corbett was among Republicans who want to kill Obamacare for political or other reasons, regardless of the impact on actual humans, so his administration instead designed a "Healthy PA" program. The 2.2 million current Medicaid recipients will be put into new plans: an essentials-only coverage (Healthy), or one with more coverage and benefits to cover the medically frail or those with chronic diseases (HealthyPlus). Both of these give less coverage than the original program, but at least the job-search requirement that Corbett originally proposed was not approved.

A third coverage option for the newly eligible allows people to choose a private doctor; eventually, those participants will have to pay premiums.

The state's Department of Human Services must handle a staggering number of people who are making the transition. That includes sending letters to the current Medicaid recipients to inform them of changes and to outline an appeals process. There were reports of jammed phone lines on the first day of enrollment.

And now, with the election of Tom Wolf as governor, Corbett's complicated contraption will no doubt be disbanded when Pennsylvania does in fact accept federal expansion of Medicaid, which Wolf says he supports. So, the bureaucratic infrastructure that was built to implement Healthy PA will have to be scrapped and a new one built to accommodate expansion.

We can't help once again lamenting the U.S. Supreme Court's decision claiming that imposing federal Medicaid expansion intruded into states' rights. Such rapid change to the state's complicated system is bound to come with some glitches. Unfortunately, it's the sick and the poor who will suffer the most as those glitches get ironed out.