May 2nd, 2008

PA Access to Basic Healthcare (PA ABC) is a plan that would help hundreds of thousands of working Pennsylvanians without health insurance gain access to affordable coverage while continuing the commitment to helping doctors pay their medical malpractice insurance premiums. The plan also would help small business employers who already offer their employees health care.

PA ABC would:

• Provide more than 270,000 uninsured working Pennsylvanians access to basic health care.
• Immediately provide affordable health insurance to the 80,000 Pennsylvanians who are on the adultBasic waiting list.
• Make $42 million available for grants to small business employers who have been doing the right thing all along by providing health-care coverage to their employees.
• Assist doctors by continuing to help them pay their medical malpractice insurance premiums.
• Lower the cost of uncompensated care for hospitals, which costs us 1.4 billion a year and adds hundreds of dollars to every insurance premium.
• Lower the cost of care for all Pennsylvanians.

The legislation (SB 1137) to put this plan in place, as passed by the House in March, would cover 272,600 uninsured Pennsylvanians within five years at a cost of $1.1 billion. This money will come from:

• State money currently used to fund the state’s adult Basic program (which is partly tobacco settlement dollars)
• Federal government matching funds
• Premium payments paid by employers and employees participating in the plan

As is, the plan would also require at least $120 million in further funding to be identified and deposited into a new account to support the program. The Gov’s Budget office announced in early May that they have identified two funding sources that would raise the $120 million to fully support that account:

1. A 10 cent-per-pack increase in the state cigarette tax.
2. A 36 cents-per-unit tax on other tobacco products, such as cigars and chewing tobacco. These products are currently not taxed at all.

The budget office is assuming that as more uninsured Pennsylvanians enroll in the PA ABC program there will be less uninsured people at the hospital. Therefore, the office believes that some of the “uncompensated care” payments the state currently makes to hospitals to treat the uninsured, will be gradually redirected to the ABC program. Senate Republicans and other critics of the plan say that it’s impossible to fund over time. They are also opposed to any new taxes on cigarettes and other tobacco products. Senate Republicans plan to unveil their own health care reform plan in early June.Cover All Pennsylvanians focuses on the people and small businesses that need help the most. The vast majority of Pennsylvania’s uninsured adults are employed, and most of the working uninsured have full-time jobs. Most earn low wages, are employed by small businesses and do not have access to health insurance because of the high cost for both businesses and individuals.Cover All Pennsylvanians will be supported by the state and offered through private insurance companies. Employers can participate if they have 50 or fewer employees and if, on average, these employees earn less than the state average wage. Employers who choose to join CAP will pay approximately $130 per employee per month, and each employee will pay a premium of $10 to $70 per month depending on family income. All uninsured Pennsylvanians – no matter what size company they work for – will be able to purchase affordable health insurance through CAP.A family of four who earns up to $60,000 a year will receive help from the state paying their premiums, and all uninsured adults who earn more than that amount – 300% of the federal poverty level – can participate in Cover All Pennsylvanians by paying the full cost. Prescription for Pennsylvania eliminates the ability of businesses to get a “free ride” by failing to provide health insurance to their employees – gaining a financial advantage over their competitors and passing along the cost of their uninsured employees to the rest of the state. Now, businesses that do not provide health insurance will be assessed a percentage of their payroll.

Comparison of PA ABC and CAP

HealthNET PA : is the Senate Republicans’ counterproposal to PA ABC. According to Senate Republicans, “HealthNET PA is a $100 million blueprint that expands acess to health care and medicine to 507,000 uninsured and low-income working Pennsylvanians. It utilizes information technology to control costs and reduce health care-associated infections, and provides expanded insurance options for employers and families. ”

HealthNET PA would provide:

Healthcare Access

• SB5 (Erickson)-Community-Based Healthcare Program (CHC) provides for  the expansion and site development of health care clinics across Pennsylvania in order to provide “medical homes” for the working poor, to be funded partially by an EITC-type credit for businesses which would receive tax credits for financially supporting community clinics. This would also ease pressure on Hospital Emergency Rooms. $50M would expand services to over 175,000 new patients.
• SB1450 (Brubaker)–Establishes a Specialty Physician Volunteer Networking System to provide integrated care to approximately 159,000 uninsured low-income individuals, with a $4M appropriation.
• SB1451(Browne)-Provides Continuing Medical Education (CME) Credits for health care providers, including dentists, who perform volunteer services at clinics and in their community for uninsured low-income residents.
• SB1452 (Corman)-Improves access to healthcare by providing student loan forgiveness for physicians and dentists, who practice at least 7 years in PA.
  $10M would assist up to 1500 new doctors and dentists to stay in PA.
• SB379 (Vance)-Eliminates predatory pricing provisions to allow the sale of low-cost prescription drugs at retail establishment pharmacies
• SB1455(McIlhinney)–Creates a Free Drug Program Registry for use by individuals, clinics and other health care providers to identify companies and drugs that provide access to these resources at a cost of $1M.
• Act 14 of 2008—SB638 (Wonderling) Creates a Cancer Drug Repository in PA.

Healthcare Affordability

• SB8 (Wonderling)-provides $10M for hospital and physician office conversion to the use of Electronic Medical Records, including incentives for the use of evidence-based diagnosis and treatment protocols.
• SB819 (Wonderling)-Encourages Telemedicine expansion in PA
• SB1411 (D. White)-Establishes non-payment by private insurers for medical errors
• SB1267 (Armstrong)-Requires insurers to establish Healthy Living Discounts
• Provides $10M to fund electronic surveillance systems designed to eliminate the occurrence of Healthcare associated infections, such as MRSA as provided in Act 52 of 2007(Erickson).
• SB 1304 (D. White)-Provides for the Blues Merger Oversight

Expanded Insurance Coverage

• SB1422 (D. White)-Mini-Cobra coverage could assist 150,000 individuals for employers with 2 to 19 employees.
• SB1453 (Corman)-Extends to group policyholders the option of dependent coverage to age 30.  This extension could assist approximately 15,000 young adults.
• SB1454 (Folmer)-Creates a High Risk Pool to provide health care coverage for individuals with pre-existing conditions who cannot access private coverage.  Benefit designs will include mandate-free and HSA compatible policies.  $10M would be allocated to start up and support the operation of the pool and assist approximately 8000 individuals.
• SB 1182 (Folmer)-Establishes $5M in state tax credits for the use of HSAs.