Reality of compromise

Republican Pennsylvania Gov. Tom Corbett took a seeming step toward Medicaid expansion that advocates for the un- and underinsured have long been pressing for — but his support is not guaranteed.

As part of the Affordable Care Act, or Obamacare, states have the option to expand who is eligible for Medicaid, a federal program that provides health insurance to low-income Americans, and is often utilized by the elderly, disabled and people with illnesses such as HIV/AIDS.

The federal law allows for states to expand eligibility for those who are making up to 138 percent of the federal poverty law, and Corbett has long resisted such a blanket expansion, instead offering alternatives that for the first time this week he delineated.

The only way that Pennsylvania would participate in the expansion, Corbett decreed, is if Medicaid clients pay a monthly premium of up to $25, working-age enrollees show proof that they are working or seeking employment and, instead of using the new federal money to support Medicaid, the dollars would instead be used to purchase private insurance plans for newly eligible Pennsylvanians.

Corbett’s plan, dubbed “Healthy Pennsylvania,” is a welcome step toward the possibility of getting more than 500,000 low-income Pennsylvanians insured. However, it comes with the caveat that, unless the federal government approves Corbett’s demands, that goal is out of reach.

If compromise is to happen, all parties need to be prepared for give and take.

If some, but not all, components of Corbett’s plan gain approval, that should not mean a deathknell for progress. When the health of a half-million Pennsylvanians could be helped or hindered by this plan, it is critical that partisan politics stay out of the discussion.

Compromise can be a tricky pursuit, and requires a delicate balance of sacrifice and success, with no room for personal, or political, egos. While Corbett’s plan has glaring flaws, that a plan at all is being formulated by a governor with a track record of immobility should be cautiously celebrated.

And, if the governor is actually committed to supporting the health of our state’s citizens, he needs to also turn his attention to the General Assistance funding that he slashed — which was a vital source of income for low-income Pennsylvanians, including many HIV/AIDS patients. Recognizing the plight of the homeless populations in the HIV/AIDS and LGBT communities, as well as the specialized health issues facing these communities’ youth and seniors, would also be long-overdue steps toward a healthier Pennsylvania.

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