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<p>HARRISBURG, Pa. (AP) &#8212; Pennsylvania would lose billions of federal Medicaid dollars in a decade under Republican legislation pending in the U.S. Senate to replace &#8220;Obamacare,&#8221; according to figures released Monday by Democratic Gov. Tom Wolf&#8217;s administration.</p><p>Wolf, an opponent of the bill, released a statement that says Pennsylvania could lose $12.7 billion in 2030 alone under a high-cost growth rate in Medicaid, and $5.5 billion that year under a low-cost growth rate in Medicaid.</p><p>Starting in 2020, Pennsylvania could lose nearly $1 billion under a high-cost growth rate.</p><p>&#8220;The losses in federal funds to protect health care benefits for Pennsylvania&#8217;s most vulnerable are unacceptable and insurmountable,&#8221; Wolf said in a statement.</p><p>The Wolf administration did not explain how it arrived at those numbers.</p><p>The fate of the bill is uncertain, and a vote is indefinitely postponed.</p><p>Pennsylvania&#8217;s Republican U.S. Sen. Pat Toomey helped write the bill and says it puts Medicaid on a sustainable path. His office pointed out the bill still would allow Medicaid to continue growing. Toomey&#8217;s office said it did not have a detailed methodology for how Wolf&#8217;s administration came up with those numbers and declined to offer its own assessment of the bill&#8217;s impact on Pennsylvania&#8217;s Medicaid dollars.</p><p>Against the bill are Pennsylvania&#8217;s Democratic U.S. Sen Bob Casey, Pennsylvania&#8217;s hospitals, the Arc of Pennsylvania, the AARP of Pennsylvania and labor unions.</p><p>Pennsylvania&#8217;s largest business association for nursing homes, the Pennsylvania Health Care Association, has &#8220;significant and grave concerns&#8221; about the bill, it&#8217;s president and CEO, W. Russell McDaid, said.</p><p>Nearly 2.9 million Pennsylvanians &#8212; almost one in four &#8212; are covered by the state&#8217;s $30 billion Medicaid program, a federal-state partnership. Pennsylvania&#8217;s per capita and per beneficiary Medicaid spending is among the nation&#8217;s highest.</p><p>Opponents say paring back Medicaid payments to the states would force the states to cut reimbursements to many Medicaid enrollees, potentially including the elderly, disabled and children.</p><p>The federal government pays slightly more than half the bill for most people on Medicaid. It pays nearly the whole bill for the more than 700,000 primarily childless low-income working adults who joined Medicaid starting Jan. 1, 2015, when Pennsylvania expanded income eligibility guidelines to take advantage of the more generous federal contribution rate under President Barack Obama&#8217;s law.</p><p>Under the Senate bill, the federal government would still commit to funding the Medicaid expansion, albeit at a roughly 52 percent rate in Pennsylvania, compared to the 90 percent long-term rate under Obama&#8217;s law.</p><p>The bill&#8217;s cap on Medicaid costs also would allow that expense to rise with inflation, a rate that nonetheless rises more slowly than the program&#8217;s historical growth rate.</p><p>Pennsylvania&#8217;s hospitals get 13 percent of their total revenue, or $5 billion in payments, from Medicaid, the Wolf administration said.</p><p>The most expensive Medicaid enrollees are the elderly and disabled, accounting for fewer than one-third of all enrollees in Pennsylvania, but driving nearly two-thirds of the program&#8217;s cost. More than 1 million children in Pennsylvania are on Medicaid, and almost two-thirds of Pennsylvania&#8217;s 88,000 nursing home beds are subsidized by Medicaid.</p><p>The state already is giving nursing homes below-cost reimbursements for Medicaid patients, and the Senate bill would further seek to balance the federal budget on the backs of the frailest elderly, McDaid said.</p><p>&#8220;Very little good can come of that,&#8221; McDaid said.</p><style>
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<div class="metaInfo"><bylineMeta><p>By MARC LEVY</p><p>Associated Press</p></bylineMeta></div>

Wolf: Pennsylvania would lose billions under proposed health care bill