Official: State should OK Medicaid expansion

Local and regional health care providers gave their input Tuesday about possible Medicaid expansion that would cover hundreds of thousands of Pennsylvanians with health insurance under President Barack Obama’s Affordable Care Act.

Their testimony was accepted by several members of the state House of Representatives’ Democratic Policy Committee that met at Lycoming College’s Welch Honors Hall.

Committee members included state Reps. Michael P. Sturla, D-Lancaster, chairman; Rick Mirabito, D-Williamsport, co-chairman; and Mike Hanna, D-Lock Haven.

Other committee members present at the hearing included state Reps. Mark A. Longietti, D-Ferrell; Christopher Sainato, D-New Castle; Mark Painter, D-Limerick; and Ted Harhai, D-Monessen.

Gov. Tom Corbett said in his budget address last month that he opposed the state’s entry into Medicaid expansion because it would burden taxpayers.

States that choose to be included in Medicaid expansion would have 100 percent of the costs paid by the federal government for the first three years. After that, 90 percent would be paid by the federal government.

Sturla said that if Pennsylvania doesn’t participate, such as 24 states already have done, it’s money the state never will see again.

“Pennsylvanians are still going to pay their taxes like before. We just wouldn’t be getting $42 billion. That seems like a raw deal to me,” he said.

One of those who gave testimony was Charles J. Santangelo, chief financial officer of Susquehanna Health, who urged lawmakers to enact Medicaid expansion. He said that the health system – which has one of the busiest emergency departments in the state at the Williamsport Regional Medical Center – will continue to lose money while providing care for uninsured patients without reform.

Santangelo said that 40 percent of patients seen in the emergency room receive Medical Assistance, while another 11 percent are uninsured. He added that on a combined basis of health system hospitals, 65 percent of the services provided were to Medicare, Medical Assistance and uninsured patients.

“The combined annual shortfall is $51.5 million,” Santangelo said. “So, in other words, providing care to 65 percent of our patients results in a financial shortfall of $51.5 million that has to be absorbed by the other 35 percent of our patients – a condition similar to practically all hospitals in Pennsylvania.”

The smaller number of insured patients actually are paying significantly more for the actual cost of health care, according to Santangelo, an industry term he called “cost shifting.”

Beyond that, other ways the health system can make up shortfalls are by reducing operating costs and cutting services, he said.

He said the health system was founded by Catholic nuns on principles of charity and giving.

“Our mission is to serve the needy of the community. But often times it’s the mission services that are going to suffer,” he said.

But Santangelo didn’t say cuts are imminent.

“I don’t want to communicate that the health system is ready to pull back services,” he said.

He added that Medicaid expansion funds would not amount to a redistribution of state taxpayer dollars, “but rather an inflow of federal dollars.”

Asked if Medicaid expansion would allow the health system to institute expansion of services, Santangelo said, “I don’t see the amount of money being sufficient for expansion. It will keep our heads above water, if you will.”

Others who provided testimony included employees from Interim Health Care, Community Services Group, Living Unlimited Inc., United Home Care Workers of Pennsylvania, Roads to Freedom and several local citizen advocates.

Mirabito said information gathered from the hearing will be taken back to Harrisburg and shared with other legislators.