Updated

This is a rush transcript from "Your World," March 25, 2013. This copy may not be in its final form and may be updated.

NEIL CAVUTO, HOST: All right, as you know, we're now officially three years into the health care law, and while they had a lot of the goodies and presents up in the first couple of years, now paying for it is coming up, especially over the last year, the Medicare surtax I told you about on big purchase profits, of course medical devices fees, taxes, so sort of the unpleasant underbelly of all of this.

Who knows that better than Pennsylvania's Republican Governor Tom Corbett on how big a deal this gets to be, not only for his state, but for his governor colleagues across the country?

Governor, very good to have you back.

What do you do?

GOV. TOM CORBETT, R - PA: Thank you, Neil.

CAVUTO: Because a lot of this is on you, and implementing not only exchanges and a growing role on the part of the federal government when it comes to Medicaid.

But the argument is that even though Paul Ryan wants to have the thing done and killed off, it's like the train has left the station. It's too late for that. Do you agree?

CORBETT: Well, the train has left the station, at least for a while.

I don't know whether it's going to get derailed or not. But, in the meantime, the governors across the country, including myself here in Pennsylvania, we have to deal with what is coming forward. What I know is that really one size does not fit all the states.

Each state is so different than the other states, that we need to see real reform for the state of Pennsylvania. It might be completely different than what they need in the state of Ohio or in the state of Virginia.

I recall a statement by President Obama in 2009 to Democrats that it made no sense to put a lot more money into Medicaid without first having reform. Well, that's one of the statements that I agree with him on. But that seems to be exactly what we're doing.

And the other point that I always like to make is, this is -- people forget this is taxpayer dollars, whether it's taxpayer dollars coming from the federal government or taxpayer dollars coming from the state government. It's the same taxpayers across the country and across our various states.

(CROSSTALK)

CAVUTO: But, to your point, whatever you get, be careful what you wish for. Right? I don't want to get into the details of this plan now to cover illegals with health care, but it gets to the bigger point of added spending, where even the architect of this plan a couple of weeks ago was saying, well, a lot more problems than we envision.

I'm paraphrasing here, Governor, but you get the gist of this, that the taxes, the fees, the add-ons, the unexpected drop in part-time workers who -- who lost their health insurance and many other workers who lost their job as a result of companies taking on demanded health care insurance was much greater than even the law's strongest proponents imagined. What do you think happens now?

CORBETT: Well, I think that's exactly right.

If you recall, Speaker Pelosi said we have to pass the bill to find out what's in it. And now we're seeing the downside of that kind of thought process and not taking a very careful look at the thousands and thousands of pages to see where money is going to have to be spent and who it's going to cost.

What it's costing is business across the country, and it's costing the taxpayers across the country.

CAVUTO: So, what do you do?

Now, I know you're going to be meeting with Kathleen Sebelius, the health and human services secretary. You're going to sort of find a middle ground when it comes to these exchanges, where you will have some flexibility and the growing role the federal government plays, for example, with Medicaid.

But what are you going to do as far as -- the law is here. Is it just about a kinder and nicer way of accepting how much Pennsylvanians have to take on or what?

CORBETT: Well, we had a number of questions, and in recent month or so, HHS has been answering some of our questions, but they raise other questions and other concerns.

So we're going to discuss some of the reforms that we're exploring for Pennsylvania's programs and to see how that will work in according to HHS, whether they're going to accept what we want to do. What I know right now is that expansion is not sustainable for Pennsylvania without the reforms.

We're looking at adding 800,000 new children and adults into a program, and the cost under the ACA would accumulate to over $4.1 billion over the next eight years. I can tell you what I really want to do is to be able to provide to Pennsylvanians affordable, quality health care.

But there's key words there, affordable and quality. We currently spend more on our budget than every other state for Medicaid, except Missouri; 27 percent for the general fund budget of Pennsylvania goes to Medicaid.

CAVUTO: Wow.

CORBETT: Our average enrollee receives $7,400. That's almost $3,000 more than in the other states.

So what I need to do is look at a Pennsylvania solution to increase access to quality care, and again not that one size fits all.

CAVUTO: OK.

CORBETT: We're making our own analysis of the situation from Pennsylvania.

And after I hear from Secretary Sebelius, ask her some more questions, we will make our own decision. But right now, what I have told the General Assembly is, I can't recommend expansion at this time.

CAVUTO: Governor, we will watch closely. Thank you very much, sir.

CORBETT: Thank you very much for having me.

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