In negotiations with the Centers for Medicare and Medicaid Services (CMS), [Pennsylvania's] governor requested dozens of changes to Medicaid for the expansion group (those earning less than 133 percent of federal poverty, or $15,500). He wanted to tie cost-sharing reductions to employment and job training, for example, and increase co-pays for a non-emergency ER visit from $8 to a whopping $10.
Almost all these requests were denied. In fact, as Josh Archambault and Nic Horton noted at Forbes, “not a single ‘state-unique’ request was approved as included in Corbett’s original application. Of the roughly 24 changes he asked for, only 3 were granted, but in severely watered down forms.”