Talks on a possible Medicaid expansion in Pennsylvania appear to hinge on a meeting that isn't on the governor's schedule yet -- as well as bickering over cost estimates and whether to trust a federal IOU.

 

Gov. Tom Corbett has said one of the reasons he's not deciding "at this time" to expand Medicaid is that he's not sure he can count on federal dollars to foot all of the costs in the first few years and most of the bill thereafter.
The acting secretary of the state Department of Public Welfare, Bev Mackereth, has borrowed the argument.
She says it's not wrong to doubt the federal government's ability to deliver on funding promises, because they've been broken before.

"Special education -- the commitment from the federal government was 40 percent, we're now down at 17," she said Wednesday. "I know you all are struggling with that piece in the education portion of your budget."

But Senate Democrats say it's disingenuous, arguing special education is not an entitlement program such as Medicaid, Medicare, or Social Security, which the federal government has a legal obligation to cover.

The governor, for his part, says he won't budge on Medicaid without more assurances from the feds. He plans to meet with U.S. Health and Human Services Secretary Kathleen Sebelius. So far, no meeting has been scheduled.

The bottom line, however, according to Mackereth is that "the governor did not say no. The governor said that we need to talk to the federal government about flexibility and reform."