Pennsylvania's Governor Gets 500,000 Residents Medicaid by (Almost) Embracing Obamacare

Pennsylvania Gov. Tom Corbett has decided to provide health coverage for half a million of his state's residents. Took him long enough.

The Republican had previously refused to expand Medicaid as part of Obamacare. But he struck a deal with the federal government that would make him the 27th governor — and the ninth Republican — to agree to the expansion.

While getting Corbett on board required some concessions from the feds, his likely acceptance of the expansion is a sign of the evolving opinions about and growing acceptance of the president's signature health care law.

Different rules: In order to strike a deal, Corbett and the federal government went back and forth on a few key issues related to the expansion. Corbett wanted, for instance, a work requirement and a "lockout" provision that would drop anyone who missed a premium payment. Neither was approved.

But, as Vox notes, he was granted permission to charge higher earners (those making between $11,670 and $15,170) an extra premium, and also to bring nine private insurers into the mix for residents to choose from.

Making changes like these also gave Corbett the cover to embrace Obamacare without exactly embracing Obamacare. "From the beginning, I said we needed a plan that was created in Pennsylvania for Pennsylvania ? a plan that would allow us to reform a financially unsustainable Medicaid program and increase access to health care for eligible individuals through the private market," he said in a statement, which added he "has been clear that he would not expand Medicaid because it is an unsustainable entitlement program," even though the statement was essentially an announcement of Medicaid expansion.

More acceptance: Corbett isn't the only governor to agree to a modified form of Medicaid expansion, and it's not just Republicans looking to shift things slightly to cover themselves.

Democratic Arkansas Gov. Mike Beebe is using the expansion money to provide private insurance for residents, (somewhat) appeasing conservatives and presenting a model other governors might want to follow. Michigan and Iowa also changed their Medicaid expansions, charging some enrollees premiums and providing incentives for healthy behaviors.

All of this is good news for the president, who has been playing the long game with the health care rollout, offering lots of federal money to states in exchange for expanding Medicaid. Allowing these tweaks may not please all liberals, but it gets more residents enrolled, and provides less ammunition for anti-Obamacare candidates come election season.