Gov. Ed Rendell is gearing up for a renewed push to generate support for "Cover All Pennsylvanians," his proposal for making affordable health insurance more available to individuals and small businesses.
Consumer groups from around the state plan to rally at the Capitol tomorrow in support of the proposal.
Next week, the governor plans to begin a bus tour, appearing at town meetings in support of Cover All Pennsylvanians and insurance proposals that also are part of "Prescription for Pennsylvania," a wide-ranging health plan that he announced early this year. He plans to be in Pittsburgh Oct. 9, the first day of the tour.
At a meeting last month with top members of his administration, Mr. Rendell concluded that Cover All Pennsylvanians and insurance reform should be part of his fall legislative agenda, said Rosemarie Greco, director of the Office of Health Care Reform.
"Some tried to dissuade the governor from putting it all out there," she said. But Mr. Rendell believed that lawmakers will "want to do the right thing," she said.
Businesses have been critical of a "fair share assessment," one of several sources proposed to pay for Cover All Pennsylvanians. The assessment, consisting of 3 percent of annual payroll, would be collected from employers that did not offer health coverage to their workers.
One bill being prepared by Rep. Mike Sturla, D-Lancaster, will propose the same provisions for Cover All Pennsylvanians that were outlined earlier this year, including the 3 percent assessment, Ms. Greco said.
Another bill being prepared by Sen. Jay Costa, D-Forest Hills, would be similar to Mr. Sturla's but would not include the assessment.
Ms. Greco reiterated the governor's earlier statements that he would consider an alternative revenue source.
Gene Barr, a vice president for the Pennsylvania Chamber of Business and Industry, said his group remains "adamantly opposed to the payroll tax."
Some small employers have said the tax could put them out of business, he said.
Dan Fee, executive director of Pennsylvanians United for Affordable Health Care, said the assessment is a fair approach when more than 70 percent of the state's 900,000 uninsured people are employed.
He said a recent poll of state voters by his group found that 60 percent favored the tax for employers who did not provide insurance for their workers.
Under Mr. Rendell's original proposal, businesses could participate in Cover All Pennsylvanians if they have not offered health care for their employees in the past six months, have fewer than 50 employees and if, on average, those employees earn less than the state average annual wage, about $39,000. Businesses that join the program would pay about $130 per employee a month, and workers would pay from $10 to $70 a month, depending on income.
Other uninsured adults could also get coverage and receive help paying for their premiums if they earn less than 300 percent of the federal poverty level. Those earning more than that would pay about $280 per month for coverage.
Insurance proposals in Prescription for Pennsylvania that Mr. Rendell also plans to push would limit the ability of health insurers to consider certain factors such as health history in setting rates for plans offered to individuals and small businesses. Eighty-five percent of premiums also would have to be spent on health care, and the Insurance Department would have more authority in setting rates.
The department has been holding "listening sessions" around the state inviting businesses to share their problems with providing health coverage to their employees.
Mr. Rendell has urged that reforms are needed in part to curb the spiraling cost of health care.
State lawmakers already have approved portions of Prescription for Pennsylvania that address expansion of practice capabilities for nurse practitioners, midwives, nurse specialists, physician assistants and dental hygienists. They also approved new reporting requirements concerning infections acquired in hospitals and nursing homes, provisions that were modified from the original plan.
Through executive order, the governor also has created a commission aimed at improving care and reducing costs of treating chronic disease.
Proposals aimed at expanding access to health care and making other improvements are being implemented in several states, said Jennifer Tolbert, principal policy analyst for the Kaiser Family Foundation.
A state plan to increase coverage in Massachusetts continues to move forward, for example, and Vermont's Catamount Health plan to extend coverage to the uninsured should become available this month, she said.
But in other states, such as Pennsylvania and California, major proposals are still being debated, Ms. Tolbert said. Still other states have turned over proposals to commissions for more study.
"What this shows is broad-based reform is hard to do," she said. "The financing issue remains a challenge for states."
Joe Fahy can be reached at firstname.lastname@example.org or 412-263-1722.