Fallout feared from Medicaid stance

The state’s failure to expand Medicaid could have serious consequences for many of the uninsured but also for the economy, according to some officials.

On the local level, the repercussions could be felt as well.

State Rep. Rick Mirabito, D-Williamsport, believes too many people without coverage most definitely will be impacted.

But there’s another concern.

Failure to expand Medicaid will hurt Susquehanna Health, one of the largest employers in the area.

“Here’s the concern I have. There are more than a half million rural people in Pennsylvania who are working people,” he said. “They often work two jobs. They don’t make enough money to buy private health insurance, and they don’t qualify for Medicaid. That sends the wrong message. When they have a problem, they tend to use the emergency room.”

Mirabito noted that the emergency room at Williamsport Regional Medical Center is among the busiest in the state.

Susquehanna Health Chief Financial Officer Charles Santangelo said that the health system provides nearly $5 million in charity care per year.

“Nevertheless, many uninsured avoid seeking ongoing medical care because of the lack of health insurance. This often results in the uninsured being seen in the emergency room when the need for care is acute. This is not the preferred way in which health care should be delivered nor is it the most cost-effective approach. Striving to insure all our patients is the best approach to keeping patients healthy and for properly supporting the health care system in our community. This prescription should be employed throughout the state.”

Medicaid expansion, he noted, would provide health coverage for some 350,000 low-income, uninsured adults. Of that total, about 15,000 live in Lycoming County and another 6,300 in Tioga County.

Mirabito said Gov. Corbett has been opposed to expanding Medicaid in the state.

He’s not sure how it all will play out.

“I think there are more people in the House who believe it doesn’t make sense to cut ourselves out,” he said. “All you need is an emergency in the family to see how disastrous this can be.”

National firm Jackson Hewitt Tax Service recently released a report titled “State Medicaid Choices and the Hidden Tax” in which it was stated that states failing to expand Medicaid for adults leave their large employers exposed to higher federal tax penalties under the Affordable Care Act.

The federal tax penalties to employers could total $1.03 billion to $1.55 billion each year in the 25 states that have not yet expanded Medicaid for adults. In Pennsylvania, it could mean employers paying $52 to $77 million each year in federal tax penalties, according to the report.

Mirabito said he had little knowledge of the federal tax penalty burdens employers could face.

However, he said, failure to expand Medicaid will shift health care expenses to those who already are paying for coverage.

State Rep. Garth Everett, R-Muncy, said he’s been contacted by some medical groups that favor Medicaid expansion.

Still, he’s not sure there is a definitive answer as to whether it’s a good idea.

“There are mixed feelings on this,” he said.

Everett said that expanding Medicaid at a time when federal funding has become less than a sure thing may not be a good idea.

“I don’t think there is anybody who can tell you exactly how it’s going to work out,” he said.

Williamsport/Lycoming Chamber of Commerce President and CEO Vincent Matteo said he hasn’t received much feedback from businesses concerned about federal tax penalties.

He agreed that some aspects of the Medicaid issue could pose some concerns.

“A lot of businesses see this governor as pro-job and pro-business, and they back him on it,” he said.

Santangelo said the health system’s goal is to keep patients as healthy as possible.

“But to achieve this important goal, as many people as possible must have health insurance. That’s why Susquehanna Health and hospitals across the nation support health reform as a way to secure health insurance for more than 30 million uninsured Americans, and why we support the expansion of Medicaid to more low-income adults.

“It is also the reason Pennsylvania hospitals agreed to accept $8.1 billion in lower Medicare and Medicaid payments over the next 10 years to help make this coverage expansion happen,” Santangelo said.