Pa. House okays health plan for uninsured adults

March 12, 2008 6:01:43 PM PDT
A billion-dollar-plus plan to help about 270,000 uninsured Pennsylvania adults get state-subsidized health coverage cleared a major hurdle Wednesday in the state House. The 114-81 vote followed a nine-hour debate during which backers promoted the measure as the next logical step to follow recent state laws that cover children and pay prescription costs for the elderly. The amendment still needs a final House vote and faces an uncertain fate in the Senate.

The sponsor, Rep. Todd Eachus, D-Luzerne, said it is nearly impossible to survive in modern society without health insurance.

"For House Democrats, access to affordable health care to working families is the key in all of our districts," he said after the vote.

Minority Leader Sam Smith, R-Jefferson, said he was concerned about the price tag, which is expected to reach $1.1 billion by 2012-13.

"This program, fully implemented as it's proposed, is going to require a huge increase in revenues to properly run it and execute it in a fashion that would meet the expectations that are being set forth," he said.

Funding would come from the federal Medicaid program, premiums paid by the people who are covered, tobacco settlement money currently used for the state's existing health insurance subsidy for adults, and money that helps doctors pay medical malpractice insurance premiums.

Legal U.S. residents ages 19 to 64 who meet income guidelines and have gone six months without insurance would qualify for what would be known as the Pennsylvania Access to Basic Care program.

People at higher incomes would pay monthly premiums.

The money also would help companies with fewer than 50 employees provide health insurance as long as coverage is offered to each employee, and half the employees participate. Companies would also have to pay relatively lower wages to qualify.

"What we're saying is, if you pay your employees crappy, you'll qualify for a grant, but if you don't, you won't," said Rep. Scott Boyd, R-Lancaster. "It doesn't make any sense."

The program would be similar to the adultBasic insurance program that currently covers about 55,000 people, and eliminate adultBasic's 80,000-person waiting list. But it would add four types of coverage to what is available under adultBasic: prescriptions, behavioral health, prevention and wellness, and chronic disease management.

Physicians would still be eligible for the malpractice subsidy if they consent to treat patients covered by the new health care program as well as those under the "Cover All Kids" health insurance program passed in 2006.

A spokesman for Democratic Gov. Ed Rendell, who wants to cover all 800,000 uninsured Pennsylvania adults, said the governor was supportive of the legislation as a step in the right direction.

Republicans failed in an effort to have the bill sent back to the Insurance Committee, arguing that the legislation was riddled with holes and needed public hearings.

"Surely those people who provide medical care - doctors, surgeons, therapists, insurance companies - and those who need medical care, the 12 million Pennsylvanians we represent, have an interest in this bill and whether this bill is the right solution," said Rep. Kate Harper, R-Montgomery.

Democrats accused Republicans of obstructionist tactics, but Smith said his caucus was committed to its own plan and worried that Eachus' approach would lead to higher taxes.

"The Senate is going to fall down much closer to our side of the ledger than what these guys have proposed," he said afterward.

Eachus said that if additional money could be found in future state budgets, he will support widening the program. His legislation was an omnibus amendment to a bill that already passed the Senate that extended the doctors' malpractice subsidy into 2008.

Republicans objected to the diversion of medical malpractice funds, but a series of GOP amendments to address that issue were defeated along party lines.


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