By Pat Loeb

PHILADELPHIA (CBS) — The administrator for Medicaid has announced changes to the program that could make it harder to get.

The approach might sound familiar to Pennsylvanians who remember former Governor Tom Corbett’s approach to the program.

Administrator Seema Verma, in a speech to the National Association of Medicaid Directors on Tuesday, said she would encourage states to come up with rules such as drug test and work search requirements.

They are the sorts of hurdles Corbett wanted to build into a Medicaid expansion but had blocked by the Obama administration because the point of the expansion, part of the Affordable Care Act, was to get more people covered.

“Our vision for the future of Medicaid is to reset the federal-state relationship and restore the partnership,” Verma said, according to a news release about the speech. “We will not just accept the hollow victory of numbers covered [in the program].”

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Verma’s office declined an interview request.

“It appears the whole idea is really designed to kick people off the program,” said Marc Stier of the Pennsylvania Budget and Policy Center.

That was also the complaint when Corbett first proposed his “Healthy PA” plan, which he called an alternative to Medicaid expansion. Corbett had resisted the expansion, forfeiting millions of dollars in federal subsidies, before proposing that the state accept the federal money but put conditions on enrolling new recipients.

His plan was made moot when Tom Wolf was elected governor.

Wolf opted for a traditional expansion, which allowed 166,327 additional Pennsylvanians to get health care through Medicaid.

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Stier warned, though, that all 650,000 of the state’s recipients would be impacted if a governor, in the future, sought again to impose conditions on them.

“Especially working people,” he said, “who don’t have time to sit in government offices and fill out even more paperwork. They won’t be able to do that and they’ll lose their insurance.”

Stier says the approach also makes no economic sense, potentially creating a large bureaucracy for a relatively small group of recipients.

He estimates about 95 percent of Pennsylvania recipients are either already working (55 percent) or ill, disabled, in treatment, caring for children, in school or retired (40 percent).

“The administrative costs of this program would be far more than what they would save,” he says.

In addition, he says, people with chronic conditions who don’t have insurance may become unable to work, compounding the problem Verma says she wants to address.

“The long-term effects are not just disastrous for the people who need insurance,” says Stier. “They’re disastrous for the whole community.”