Pa. Hospitals Press Lawmakers for Medicaid bill

Pennsylvania's top hospital lobbyists were in the state Capitol on Saturday pressing lawmakers to pass legislation to potentially expand Medicaid eligibility to hundreds of thousands of adult Pennsylvanians under the 2010 federal health care law - and shore up the bottom lines of hospitals around the state.

The hospital lobbyists were among a crowd of advocates on subjects from liquor to gas drilling plying the hallways of the Capitol during an unusual weekend voting session as lawmakers scramble to pass an on-time budget and other high-priority legislation before they depart Harrisburg until fall.

Andy Carter, the president and chief executive of the Hospital and Healthsystem Association of Pennsylvania, said the Medicaid expansion is crucial to ensuring that hospitals get help covering their costs to care for the uninsured.

“Thirty percent of hospitals run at a negative operating margin,” Carter said. “That's going to get worse ... and I expect we'll lose some of those hospitals if we don't shore up the work they do for the uninsured.”

Carter said a study performed for the association concluded that the federal health care dollars would bring $3.2 billion a year into Pennsylvania, boosting the economy as well as the bottom lines of hospitals.

But hospitals that treat a higher proportion of the poor or uninsured are going to lose $1 billion in the coming years in aid under a separate provision of the federal health care law, the association said. If the Medicaid expansion doesn't pass, even more hospitals will face losses and cutbacks, and will have to engage their communities and local businesses in tough conversations about helping them stay afloat, Carter said.

Hospitals typically try to make up their losses covering the uninsured by earning investment gains, raising philanthropic donations and negotiating higher reimbursements from private insurers.

The bill won approval from a Senate committee Friday night and is expected to pass the full chamber later this weekend. But support for it is uncertain from Gov. Tom Corbett and the more conservative state House.

With lawmakers laboring to wrap up by Sunday night, the Senate's Republican majority is cooperating with Democrats to pass the Medicaid expansion legislation in an eleventh-hour effort to force the hand of Gov. Tom Corbett, a Republican, and potentially hostile House Republican leaders who are worried about the potential cost to Pennsylvania taxpayers.

Democrats are solidly in support of it, while Senate Republican leaders said they negotiated it with input from Corbett's office, and wrote certain conditions into it to make it more amenable to Republicans who may otherwise oppose it.

Those 14 conditions include employment and job search requirements, cost-sharing by enrollees and maximized use of private insurance plans instead of the traditional Medicaid plan. It also would revoke an expansion if the federal government backtracks on its pledge to pay for nearly all the cost to enroll adults up to 138 percent of the federal poverty level, or about $15,000 for one person.

Ultimately, the governor's office would need to submit a plan that wins federal approval for the expansion. The bill requires Corbett to submit a plan by Oct. 1 in an effort to compel expanded Medicaid eligibility in Pennsylvania by July 1, 2014.