Pennsylvania Gov. Tom Corbett said at his annual budget address Tuesday that he "cannot recommend" expanding Medicaid in the Commonwealth.

"At this time, without serious reforms, it would be financially unsustainable for the taxpayers, and I cannot recommend a dramatic Medicaid expansion," Corbett said at his annual budget address in Harrisburg.

 

Corbett said he wrote to Secretary of Health and Human Services Kathleen Sebelius in Washington Tuesday, advising her of his position.

His message: that Pennsylvania cannot afford to "expand a broken system" without clear guidance about what it would cost taxpayers, and more flexibility in administering the Medicaid program.

In his speech, he quoted a 2009 statement from President Obama.

"'We can't simply put more people into a broken system that doesn't work'", Corbett said, quoting the president. "He was right."

The expansion of Medicaid is an optional provision of the 2010 Affordable Care Act, commonly referrred to as Obamacare.

The federal government would cover the entire cost of those newly eligible for the first three years of expansion.  Federal contributions would start decreasing toward 90 percent after that.

"I think the governor is leaving a lot of money on the table," said Drexel University health law professor Rob Field.

He said the decision may leave many single, poor adults uninsured.

"Those who are going to be too rich for Medicaid under the existing formula, but not rich enough for subsidies in the [state health] exchanges," Field said. "It's going to hurt a lot of people who are going to be caught in this never-never world and not be able to afford insurance."

The Delaware Valley Healthcare Council has previously said that uncompensated care cuts hospitals faced under the Affordable Care Act were supposed to be offset by higher numbers of insured patients, including those on Medicaid, so ditching the expansion would hurt area hospitals.

Estimates about what an expansion would have cost Pennsylvania vary: the left-leaning Urban Institute put the figure at around $2 billion over 10 years, while the Corbett administration figured it at a billion through fiscal year 2015-2016.

Estimates for the number of Pennsylvania residents who would have become eligible also vary as well, but would number at least several hundred thousand.

Jennifer Stefano, Pennsylvania director for the conservative group Americans for Prosperity applauded the Governor's move, saying states can't count on the federal promise to pick up most of the tab for new eligibles.

"The sitting Congress of the United States today, in 2013, cannot guarantee what money future congresses will ever give the states," Stefano said.

Drexel health law professor Field said he saw the Governor's comments as a "flat out refusal," but some, including Antoinette Kraus, director of the Pennsylvania Health Access Network, hope the verdict changes as the legislature and Governor's office commence budget wrangling.

"The Governor put forward his budget today, the Senate and House will follow suit, so we're hoping that members of the General Assembly will look at this seriously and understand the economic benefit to Pennsylvania and put it in their budget," Kraus said.

According to The Advisory Board, Pennsylvania is the eleventh state to reject a Medicaid expansion. Nineteen states and the District of Columbia have decided to participate.