The public debate over Gov. Ed Rendell's health plan came to Pittsburgh yesterday, with concerns raised over some of the proposed funding sources and provisions to expand the responsibilities of nurse practitioners.

The House Insurance Committee opened two days of public hearings at Chatham University on House Bill 700, which contains a number of provisions for implementing the governor's wide-ranging plan. The hearings, part of a series to be held around the state, continue today at 10 a.m. in the university's Eddy Theatre.

At a news conference before today's meeting, consumer groups will urge approval of the governor's plan, which calls for a number of measures aimed at cutting health-care costs, improving quality and making health insurance more affordable for people who lack coverage.

But yesterday's hearing underscored some of the challenges facing the proposal.

The biggest is a proposed penalty, consisting of 3 percent of annual payroll, for employers who don't offer workers health coverage, said state Rep. Tony DeLuca, D-Penn Hills, the committee's chairman.

Mr. DeLuca said he anticipated more support for some of the plan's other provisions, such as efforts aimed at eliminating the costly infections that patients can acquire in hospitals.

The plan calls for a new program, Cover All Pennsylvanians, that would provide more affordable, basic coverage to small businesses and uninsured people through private insurers. It also would impose new requirements on hospitals and health insurers, ban smoking in workplaces, and allow nurse practitioners and other health professionals to practice to the full extent of their training.

At yesterday's hearing, nurse anesthetists advocated for provisions in the House bill that would allow them to practice more independently, without supervision from physicians.

Doing so would cut costs and expand access to care, said Dr. Art Zwerling, a certified registered nurse anesthetist and president-elect of the Pennsylvania Association of Nurse Anesthetists.

But Dr. Erin Sullivan, president of the Pennsylvania Society of Anesthesiologists, said expanding the scope of practice for nurse anesthetists "will not increase access or cut costs." She and the society's president-elect, Dr. Joseph Answine, said the current arrangement for physician supervision should be maintained.

Others who testified raised additional concerns about the governor's plan.

John Lewis, president of Armstrong County Memorial Hospital, said community hospitals would face significant financial challenges in meeting a variety of new requirements, including establishing uniform admissions criteria and billing practices and implementing electronic surveillance systems for hospital-acquired infections.