By Barbara W. Gold

and Stephen F. Gold

Despite an unemployment rate of 7.6 percent in April, Pennsylvania still hasn't decided to accept $3.8 billion a year from the federal government to expand Medicaid. The money, promised for each of the next three years, would not only increase health care and services to nearly 650,000 low-income people, but would also provide much-needed jobs.

Gov. Corbett has written that the expansion would be "fiscally unsustainable without significant reforms to the program itself." He wants "the federal government to provide flexibility and independence in crafting our state's programs."

Under the program there would be 100 percent federal funding for Medicaid expansion until the end of 2016. What's "fiscally unsustainable" about that? No "significant reforms" will change that fact. No "flexibility or independence" is needed.

After 2016, Pennsylvania could decide whether to continue care for this expanded population. If so, then the most it would pay would be 10 percent of the costs. The federal government would pick up the other 90 percent.

The nonpartisan Pennsylvania Economy League estimates that, with the expansion, between 2013 and 2022, the amount of new health investments would total $40.6 billion. About $37.8 billion would come from the federal government; Pennsylvania would pay $2.8 billion. During that time, Pennsylvania would save the $412.5 million it spends annually in health-related programs that are paid for only by the state. That money could instead be used for education, employment, or environmental programs.

In the book The Body Economic: Why Austerity Kills, authors David Stuckler and Sanjay Basu point out that every dollar invested in public health yields as much as $3 in economic growth.

Three times $40.6 billion will have a tremendous economic impact in Pennsylvania. Instead of setting up artificial barriers, our governor should be planning how to use that growth to benefit the unemployed.

A May 13 report by Pennsylvania's Independent Fiscal Office concluded that Medicaid expansion would provide annual statewide increases in taxable earmings and income of $2.1 billion, personal corporate income taxes of $65 million, and sales and use taxes of $35 million. It said the state's general fund revenues would rise by $100 million. The bottom line: an average annual net budget impact of $255 million.

But those are just numbers. Unemployment causes depression, anxiety, and other serious health crises to our citizens. The unemployment crisis alone should be enough incentive to move the governor beyond the political posturing that helps no one.

Barbara W. Gold, M.D., is a pediatrican. Stephen F. Gold is a disability rights attorney. E-mail them at barbarawgold@gmail.com and Stevegoldada1@gmail.com.