States worry over expanded Medicaid costs

The health care bills now headed to a Congressional conference committee require states to serve more people through Medicaid. But will this approach actually punish states such as New Jersey and Pennsylvania, which have already been generous in expanding the program?

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The Senate health bill would require states to offer Medicaid to Americans making up to 133 percent of the federal poverty level. Last year, the poverty line was about $18,000 for a family of three.

Right now, states have a lot of leeway to decide which residents should be eligible for Medicaid. That's an insurance program for the poor that is jointly funded by the feds and the states.

Field: Congress has to find a way to keep those laggard states up to standards and to get them to provided decent coverage.

Robert Field is a professor of law and public health at Drexel University.

Under the Senate proposal, the federal government would initially pick up the full cost of enrolling "newly eligible" people. But in later years, the federal reimbursement would be higher for states that haven't yet expanded Medicaid coverage, lower for those that already have.

Field says Pennsylvania should cry "no fair."

Field: Pennsylvania is more generous than most other states in terms of Medicaid, and the proposal in the Senate bill is another example of no good deed goes unpunished.

Pennsylvania lawmakers are complaining loudly and Field says Congress will likely broker an agreement that is fairer to all states.