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Spinal Injury

For Tom Corbett, a diagnosis of political cowardice

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As Gov. Tom Corbett heads into the backstretch of his term, he's garnered a reputation as someone willing to do almost anything for the big-money players. The drilling industry gives him campaign contributions, UPMC gives him hockey tickets ... and supposedly he rolls right over.

We should be so lucky. The truth is, Corbett is dithering over a plan to increase medical coverage for the poor — a plan supported not just by unions and activists, but by hospitals too. 

At issue is an Obama administration proposal to expand state Medicaid programs, which cover health-care costs for low-income Americans. Accepting the offer to expand Medicaid could provide health coverage to some 650,000 Pennsylvanians, with the feds footing most of the bill. The Hospital Association of Pennsylvania, which represents hospitals like UPMC, backs the proposal: "Medicaid expansion would provide substantial benefit to the physical and fiscal health of Pennsylvanians, the Commonwealth and its hospitals," Association CEO Andy Carter has said. It's probably one of the few positions the association has in common with healthcare unions.

Corbett hasn't rejected the proposal, exactly. Instead, he's spent months saying he needs more information, even after a meeting last week with an Obama cabinet secretary, Kathleen Sebelius.

During his February budget address, Corbett insisted that "Washington must provide a clear answer about what this expansion would cost the taxpayers of our state." As it stands "at this time," he added, "I cannot recommend a dramatic Medicaid expansion." 

Actually, we have a pretty good idea of what the costs will be. While the feds have pledged to pay 100 percent of the costs through 2016, the state will have to help pay a share afterwards. The RAND Corporation estimates the state's share will rise "substantially" — by about 10 percent of what it currently spends. But RAND, in a study compiled for the Hospital Association, also notes the state will get an extra $2.5 billion in federal money each year, helping shore up some 35,000 medical jobs. Any way you slice it, Pennsylvania comes out ahead.

What's really going on here? 

Corbett is showing all the symptoms of someone worrying about his re-election. He's facing a potential GOP primary challenger next year: Montgomery County Commissioner Bruce Castor. "If Gov. Corbett flip-flops on Medicaid, as it looks like he may do, he is really going to be in trouble," Castor spokesman Joe Stern told me last month. "I would liken it to Arlen Specter's flip-flop on [President Obama's 2009] stimulus bill, which effectively ended his career."

You might not think such threats would faze Corbett: The only people who don't hate him are the right-wingers Castor claims to speak for. While only a third of voters approve of the job Corbett is doing, a January survey by Public Policy Polling shows that self-identified "very conservative" voters back him by a 50-to-28 margin. Meanwhile, arch-conservative governors elsewhere — Arizona's Jan Brewer, Florida's Rick Scott, New Jersey's Chris Christie — support the Medicaid expansion.

But Corbett, having alienated everyone else in Pennsylvania, can't afford to lose conservatives. And even if he did sign off on expanding Medicaid, it might not pass the Republican-controlled legislature. Already, a handful of Harrisburg legislators have issued a statement fretting about how "corporate interests urge spending to supposedly help the poor; spending that ... puts money into their own pockets." Apparently, in today's GOP, greed is OK as long as it only helps rich people. Big employers can get anything they want ... except policies that might benefit the rest of us too directly.

The Republicans also fretted that federal promises to pay for Medicaid "are dubious at best, especially considering ... the federal government's finances." After all, they write, the government is already "withdrawing the deployment of an aircraft carrier group to the Persian Gulf." And if we can't spend untold sums playing cops in the Middle East, how can we afford a luxury like health care for our own people?

Perhaps the worst thing about Corbett is that he isn't as bad as the GOP gets. And the more you realize that, the more you almost feel ... sorry for him. 

There, I said it. Let the healing begin!

In fact ... seriously, Governor. When it comes to expanding Medicaid: Let the healing begin.

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