Nov 7, 2013 2 min read

HARRISBURG – U.S. Sen. Bob Casey is asking Gov. Tom Corbett to embrace an expansion of Medicaid to ensure that federally funded health insurance is available to hundreds of thousands of Pennsylvania’s working poor when it becomes available next year.

In a Wednesday letter provided to the Associated Press, Casey warned Corbett that refusing the Medicaid expansion unnecessarily penalizes people who would otherwise have coverage beginning Jan. 1 if the federal government does not agree to changes in the program being sought by Corbett.

“Expanding Medicaid on Jan. 1, 2014, would allow you to pursue broader reforms without denying access to quality, affordable care to thousands of Pennsylvanians,” Casey wrote.

A Corbett spokesman said he was not aware of any such plans.

Corbett, a Republican, is a critic of Medicaid and as attorney general unsuccessfully sued to overturn President Barack Obama’s signature law that pledges federal funding to largely underwrite coverage for millions of Americans. Casey, a Democrat, supports the law.

In the meantime, Corbett is asking the Obama administration for permission to use federal Medicaid expansion dollars to pay the premiums for newly eligible adults to get private insurance in a new health care marketplace instead of being used to expand the traditional Medicaid coverage that typically pays lower reimbursements to doctors and hospitals.

The Corbett administration estimated that 520,000 more Pennsylvanians could get health insurance under broader eligibility guidelines that include adults making up to 133 percent of the federal poverty level, or about $31,000 for a family of four.

In addition, Corbett wants to pare back benefits for able-bodied adults who already are on Medicaid and require the unemployed and able-bodied who are seeking Medicaid coverage to search for work through an online job clearinghouse set up by the Corbett administration.

Corbett first made his proposal public Sept. 16, and it is not clear whether the Obama administration will agree to Corbett’s conditions, or how long it would take to come to an agreement.

One problem is that private insurance policies cost much more than the traditional Medicaid program, and it is not clear who would pay the difference or how that gap would be eliminated.

Other elements of Corbett’s Medicaid plan could run into trouble. Analysts say Corbett’s proposals to impose a job-search requirement and to impose premiums on people who earn below 100 percent of the federal poverty level are not allowed by federal law.