Call it the first act of the governor’s race.
The slow-motion arc of Pennsylvania’s budget negotiations — with a backdrop of a huge deficit, potential credit downgrade and two-week-old deadlock — has served as a sort of first debate stage for Democratic Gov. Tom Wolf and the would-be contenders hoping to contest Wolf’s re-election bid next year.
It is an early opportunity to boost their candidacies, and hurt an opponent, in a setting being watched closely by insiders.
The material is rich: Wolf unsuccessfully sought to get the huge Republican House majority to sign on to a tax increase that Wolf said would be big enough to avert another downgrade to Pennsylvania’s battered credit rating.
Wolf then allowed a nearly $32 billion budget bill to become law, despite the fact that his own budget office says the state’s existing tax collections can’t support it for a full fiscal year. He did not sign it, he did not veto it and he did not use his line-item veto power to strike out some of the spending in it to bring it into balance.
Why should Congress have all the fun?
Because just as debate over federal health care policy is about to reach its mid-summer boiling point, Republican lawmakers here are asking the Wolf Administration to move on Medicaid reforms in the state budget package.
It looks like another potential flashpoint in the effort to finish the state’s $32 billion general fund spending plan for the fiscal year that started July 1.
Medicaid, the primary public medical assistance program for the poor, blind and disabled, is one of the biggest cost-drivers in state government because of the runaway train nature of health care costs.
Up Route 120 in north-central Pennsylvania, in an old logging town amid a seemingly endless swath of state forests pocked with hunting camps and one-lane bridges, sits one of the most isolated hospitals in the state.
Bucktail Medical Center, a one-story building on the outskirts of town, doubles as the local nursing home. It has two emergency-room bays, 21 acute-care beds, one physician on hand at any given time, and an ever-precarious bottom line. At a larger hospital, the nursing director’s list of duties would employ five people. Officials here are still saving up to buy their first CT scanner.
And as the GOP’s health-care bill winds its way through Congress, the staff is watching with bated breath. Like many other rural hospitals known as “critical-access hospitals,” it relies heavily on federal funding from Medicaid and Medicare reimbursements — for Bucktail, which has a $6 million operating budget, it’s nearly 80 percent of its revenue.