By Valerie Arkoosh

and Marc Stier

Imagine a new federal program guaranteed to provide Pennsylvania with $43.3 billion between 2013 and 2022 for repairs to roads and bridges. Imagine that the program is paid for entirely by the federal government for the first three years. After that, Pennsylvania will have to put in $4 billion. Imagine that despite the expenditure, Pennsylvania saves a greater amount because the new federal funding would replace almost $4 billion in state funding. And imagine that the new funding would create tens of thousands of jobs in the state and generate millions of dollars in state and local tax revenue.

Can anyone imagine Gov. Corbett turning down this deal? Of course not.

Yet in his budget address Tuesday, Corbett did just that, failing to embrace $43.3 billion from the federal government over 10 years to expand Medicaid, the health insurance program that covers seniors in nursing homes, pregnant women, children, and the disabled.

What is the stumbling block? The only difference between the imaginary deal and the actual deal to expand Medicaid is that the latter will provide 719,000 Pennsylvanians with a comprehensive health-insurance package. By itself, the Medicaid expansion will cut the number of uninsured Pennsylvanians in half. It will provide all of us with a solid guarantee that we will never be without medical care.

If we take the money to expand Medicaid, Pennsylvania will receive $43.3 billion over 10 years from the federal government. And if for any reason the money does not come to Pennsylvania, the governor can cancel the expansion at any time.

Taking federal money to expand Medicaid requires Pennsylvania to spend $4 billion over 10 years. But roughly $2 billion will be saved because federal money will replace funding for General Assistance-related programs. More than $850 million will be saved because the state will not have to compensate hospitals for ER care for the uninsured. And between $800 million and $1.4 billion will be available for county health services, where harsh cuts have alrady taken place.

All that new spending will create tens of thousands of jobs. The new jobs in health care will be for people with all levels of education and training, from doctors to nurses to administrators to therapists to technicians to orderlies.

New health-care workers will spend their wages on other goods and services so every sector of our economy will benefit. The state and local governments will receive millions of dollars in new tax revenues.

In sum, the state would save more money by taking federal dollars for expanding Medicaid than it would spend. And since we are already paying taxes to the federal government for the program, the only question is whether our taxes would come back to Pennsylvania or be spent in other states.

If we don't take the money, hospitals will not have funds to replace scheduled cuts of $8.1 billion in federal payments for care of the uninsured. Some hospitals in urban and rural areas might not survive this loss.

Pennsylvanians thrive when we create shared prosperity, strengthen working families, and treat all people with dignity and respect. Access to secure and affordable health care for working families and small businesses helps create strong families, growing businesses, and robust communities.

Even if the conservative Republicans who run Harrisburg have ideological disagreements with Democrats about the size of government, our political officials have the responsibility to make pragmatic decisions that benefit us all at the lowest possible cost.

No one would turn this money down if it were for roads and bridges.

Take it, Gov. Corbett.

Valerie Arkoosh is the immediate past president of the National Physicians Alliance. Marc Stier is the former state director of Health Care For America Now. E-mail them at and