By Sharon Ward, Third and State

There is growing bipartisan agreement that the optional expansion of Medicaid provided by the Affordable Care Act is too good an opportunity to pass up.

This month, the Governors of Arizona and North Dakota, both Republicans, announced their intention to opt-in to the Medicaid expansion, joining their counterparts in Nevada and New Mexico. To date, 14 states have decided to expand Medicaid in 2014, and another seven are leaning toward expansion. Pennsylvania remains among the 21 undecided states.

By agreeing to expand our Medicaid program just slightly beyond what Arizona voters have twice mandated, we will:

• Protect rural and safety-net hospitals from being pushed to the brink by their
growing costs in caring for the uninsured;
• Take advantage of the enormous economic benefits — inject $2 billion into our
economy — save and create thousands of jobs; and,
• Provide health care to hundreds of thousands of low-income Arizonans.

Saying ‘no’ to this plan would not save these federal dollars from being spent or direct them to deficit reduction. No, Arizona’s tax dollars would simply be passed to another state — generating jobs and providing health care for citizens in California, Colorado, Nevada, New Mexico or any other expansion state … With this move, we will secure a federal revenue stream to cover the costs of the uninsured who already show up in our doctor’s offices and emergency rooms … Weigh the evidence and do the math. With the realities facing us, taking advantage of this federal assistance is the strategic way to reduce Medicaid pressure on the State budget. We can prevent health care expenses from eroding core services such as education and public safety, and improve Arizona’s ability to compete in the years ahead. I’m committed to doing this, and I want you on my side. Let’s work together in an atmosphere of respect and do what is BEST for Arizona.

For Pennsylvania, the expansion of Medicaid is projected to bring in $17 billion in new federal investments by 2019, while expanding coverage to between 482,000 and 683,000 uninsured adults.

When Governor Corbett gives his budget address on February 5, he will offer a glimpse into the state’s plans to take advantage of this opportunity. Opting-in will create jobs, strengthen our health care system and provide health coverage to working parents, veterans, and seniors.

Governor Corbett and the Pennsylvania General Assembly should consider the benefits and savings that come with a Pennsylvania Medicaid expansion as well as the price of forgoing this opportunity — fewer jobs, a weakened health care delivery system and hardworking people without affordable insurance.

By Michael Wood, Third and State

Federal health care reform is moving forward thanks to the U.S. Supreme Court’s ruling last year — and it is a great deal for Pennsylvania. Unless the state decides to “opt out,” Medicaid coverage will be expanded to include many Pennsylvanians who are uninsured.

One group that will benefit immediately are parents with incomes up to 133% of the federal poverty level ($25,390 for a family of three). The benefits don’t end there: others who don’t receive health coverage through their work will be able to buy insurance on a competitive health marketplace or exchange — making coverage more affordable.

However, if Governor Corbett prevents the Medicaid expansion, it will create a coverage gap for families between 46% and 100% of poverty, as the chart below shows (click on it for a larger view).

Those families between 46% and 100% of poverty earn too much to qualify for Medicaid (for a family of three, this means earning over $8,781 but less than the federal poverty line of $19,090). These families won’t receive Medicaid coverage, and they won’t receive subsidies to buy health coverage.

We all benefit when more people have health coverage. Let’s make the right decision in Pennsylvania and expand Medicaid coverage.

By Chris Lilienthal, Third and State

With the election decided, it is now clear that the Affordable Care Act is here to stay. That’s great news for Pennsylvanians, some of whom have already begun to benefit from the health reform law, and many others who will see more gains as major provisions take effect in 2014.

As Judy Solomon writes at the Off the Charts Blog, a key provision of the law will allow states to expand Medicaid to cover low-income adults earning up to 133% of the poverty line, with the federal government covering most of the costs:

The question now is whether some states will squander this opportunity to cover millions of uninsured Americans.

Coverage for more than 11 million poor, uninsured adults is at risk if states don’t expand Medicaid, according to the Urban Institute.

As you can see in the chart above, Pennsylvania is among the states that have not made a clear decision on the Medicaid expansion. 

Failing to expand Medicaid would squander the opportunity to boost our state economy. The Kaiser Commission on Medicaid and the Uninsured estimates that the Medicaid expansion in Pennsylvania will amount to at least $17 billion in additional federal dollars invested in the state between 2014 and 2019. By contrast, as Solomon writes, the “Congressional Budget Office estimates that if all states adopt the expansion, they will spend only 2.8 percent more on Medicaid from 2014 to 2022 than they would have spent without health reform.”

Failing to expand Medicaid would also cost Pennsylvania real money that would otherwise be saved by reducing what the state spends to provide health care in emergency rooms and health clinics to people without insurance. 

Governor Corbett and the Legislature should take steps to expand Medicaid in 2014. It will help thousands of working parents and other adults in Pennsylvania get the quality health care they need and give the state’s economy a real boost.

A blog post by Mark Price, originally published at Third and State.

The Associated Press this morning reports on competing efforts to close some tax loopholes in Pennsylvania.

• The Associated Press — Pennsylvania Republicans back proposed changes to ‘Delaware loophole’ that moves profits out of state:

After blocking similar efforts by Democrats in recent years, Republicans in Harrisburg now want to chip away at a couple of state tax provisions that benefit businesses…

A month-old bill backed by the leaders of the House Republican majority would attempt to close the so-called “Delaware loophole.” It would give the state Department of Revenue the power to stop firms — usually large, multistate companies — from using accounting sleight of hand to move profits out of Pennsylvania to a lower-tax jurisdiction in order to avoid paying the state’s 9.99 percent corporate net income tax.

To make it easier for business advocates to swallow, the bill would also take major steps long sought by the business community to lower business taxes, including gradually reducing the corporate net income tax rate to 6.99 percent in 2019…

At the same time, the Corbett administration wants to scale back part of a $73 million incentive for retailers that collect the sales tax and send it to the state in a timely fashion…

Under the proposal, retailers that get to keep 1 percent of the sales tax money they collect would be allowed to keep no more than $250 per month, which would bring another $41 million to the state in the fiscal year that begins July 1.

The Scranton Times-Tribune reports on benefits of preventive services made available by the Affordable Care Act.

• Erin L. Nissley, Times-Tribune — Millions of Pennsylvanians using health care reform benefit

More than 3.8 million Pennsylvanians have used at least one free preventive service — ranging from annual checkups to tests for specific types of cancer — offered through health care reform legislation in the past year, according to a study by U.S. Health and Human Services.

The Affordable Care Act requires many insurance plans to provide coverage without any co-pay or deductible costs for a variety of preventive health services, including screenings for colon cancer, mammograms, well-child visits and flu shots. The move is part of an increasing emphasis on providing care that helps to keep people well.

Finally, in case you missed it, we highly recommend this inventive but persuasive op-ed on economic austerity.

• Thomas De Monchaux, The New York Times — Why Less Isn’t Always More

A blog post by Sharon Ward, originally published at Third and State.

Many states have taken steps to ensure that there is a meaningful review of proposed health insurance rate increases for small businesses and individuals.

Pennsylvania, however, is headed in the opposite direction with legislation in the House and Senate that would keep more consumers in the dark and undermine the state’s ability to review most rate hikes.

House Bill 1983 and Senate Bill 1336 would extend rate review to insurance providers that currently escape any scrutiny, but they also reduce the Insurance Department’s authority to review and disapprove rates. The bill would give insurers license to raise individual and small business rates by 9.99% annually without any review at all. Small employers already struggling from the recession cannot afford continual rate increases and deserve to have better protection than this bill affords.

You can get more details in a memo that Pennsylvania Budget and Policy Center Director Sharon Ward wrote to editors and reporters today.

Under current state law, the Pennsylvania Insurance Department has some authority to review rate increases. It is not a perfect system, but the Department has used it effectively to perform rigorous reviews of numerous rate proposals. According to a recent Government Accounting Office study, in 2010, 37% of rate filings were reduced or withdrawn after Insurance Department review, ranking Pennsylvania 9th in the nation.

Instead of curtailing the Department’s authority, lawmakers should improve upon it with greater transparency, citizen input and meaningful review of all rate proposals.