Atrios raises an interesting question concerning Healthy PA. Healthy PA is the proposal by Gov. Corbett (R-PA) to expand Medicaid by using a combination of the Arkansas private option and the Michigan style health incentive/HSA program plus some gratuitous poor shaming.
I’m not sure if it’s better to just pay it and get people enrolled, or gamble on the reasonable possibility that after November a new governor will have a better plan.
I’m not a Pennsylvania political junkie, but from my understanding of Pennsylvania politics, it is extremely likely that Corbett loses this fall to any of the fairly generic/standard issue Democrats running but the Republicans are extremely likely to continue to hold one if not both chambers of the state legislature.
The biggest downside to this political gamble that the Democrats could get something better is timing. Right now, the Corbett administration has put out a request for interest/application to Pennsylvania insurance companies. If the goal is to have Healthy Pennsylvania running on January 1st, the health insurance companies have six months to do the prep work. Speaking as a plumber, six months to build a brand new product with a whole lot of strange and odd business rules is an extremely aggressive timeline. It is achievable if the Pennsylvania companies are able to keep most of their plumbers on a single task.
Now, as I understand it, the Pennsylvania governor’s term starts in mid-January. Getting anything better than Healthy PA past at least one Republican controlled chamber will take several weeks/months. At that point, the plumbing for expansion is several more months. Realistically, if anything better than Healthy PA can get passed, it probably could not be implemented until at least September 2015, more likely the start date would be January, 2016.
There is a non-zero probability that a failed Healthy PA (shot down by Dems holding most of their votes away) leading to a failed straight up Medicaid expansion.
The trade-off is Healthy PA effective January 1, 2015 OR the probability of something better on either September 1, 2015 or January 1, 2016 plus the probability of nothing. If Healthy PA is implemented, it can be tweaked, modified and improved. My moral sense says it is better to get a significant improvement in wellbeing for the most disadvantaged in society than to hold out for the possibility of something better but later with the chance of nothing. I’m mini-maxing here.