Democrats in Pennsylvania's Legislature have been the most adamant about expanding the state's Medicaid program to included hundreds of thousands more enrollees.

 

Yet the first attempt to push the issue this fall will be the work of a Senate Republican.

Senate Republicans orchestrated an effort to add Medicaid expansion language to a budget-related bill about two months ago.

It was summarily removed when it went to the House, where Republicans opposed including a major health-care initiative in an unrelated piece of legislation.

The Corbett administration also remains cool to the idea.

Now, Sen. Pat Vance, R- Cumberland, is introducing a stand-alone measure to expand the Medicaid rolls -- with most of the costs to be covered by the federal government.

But she admits it's not clear anything has changed, or which source of opposition presents the bigger obstacle.

Nearly a third of House Republicans oppose Medicaid expansion without certain reforms.

Vance has pointed to the number of conditions built into the measure.

But some senators have pointed out the proposal doesn't allow the governor to forgo an expansion if those conditions aren't met.