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LEGISLATIVE UPDATE
LEGISLATION STATUS
What’s Happening in Harrisburg:
1. The House passed Senate Bill 1137
after amending it to water down of
Governor Rendell’s Cover All
Pennsylvanians (CAP). Its new name is
Access to Basic Care (ABC). Some of
its provisions include:
A- A new government health program
(ABC) for unemployed and workers
without insurance for 180 days and new
residents after 60 days. Coverage
would be adultBasic benefits plus
prescriptions and behavioral services.
PAHU opposes the establishment because
of cost (look at Massachusetts!) and
crowd-out.
B- Because there is no emphasis on cost
controls and is portrayed as something
Pennsylvanians have a right to, PAHU
believes that it will be regarded as a
quasi-entitlement program and will be
heavily utilized.
C- Funding assumes a federal match,,
something PAHU finds uncertain. If
this were to finally pass, PAHU would
argue for an amendment making it
effective ONLY after the federal
government approved of matching funds.
D- The Access to Basic Care also uses MCARE abatement money, Tobacco
settlement money. PAHU believes that
the MCARE abatement fund should be
re-authorized without doctors being
made political pawns so that the
Governor can get what he wants.
E- One provision in SB 1137 strongly
supported by PAHU is the creation of a HIPP-like program where limited income
employees can see their share of the
premium subsidized by the state.
2. HB 2028 (PHC5) - PAHU supports the
bill as amended. PAHU believes that
true health reform means addressing
costs. Transparency and consumerism is
part of that solution.
3. House Bill 2005 would ban medical
underwriting and is more strongly
inclined toward community rating than
the bill’s original version. Because
PAHU members are deeply divided over
eliminating medical underwriting, the
Association is concentrating its file
on parts of the bill that require the
Insurance Department to develop a
basic standard of benefits for all
health plans. The fear is that it will
be a generous plan and not basic at
all. This new set of minimums means
that health plans will get pricier
(more coverage) leading to more
uninsured. Also, market innovations
such as high deductible health plans/H
S As are at risk.
4. The School Health Insurance
Consolidation Bill: Rendell wants to
provide all school teachers statewide
with the same governmental health care
program.
HB 1841 has moved through the
House Education Committee
5. PAHU has drafted language with key
house members to use agents to market
CHIP.
6. HB 2026 (Mini-COBRA) - PAHU
supports the Mini-COBRA as a targeted
bill meeting the needs of employees of
small employers. Increasing the
administrative charge will help small
business meet additional cost.
Although there is the risk of adverse
selection, we feel that the benefits
outweigh the costs. (NOTE: Not all
PAHU members support this concept.)
7. HB 2098 (non-pay of adverse events)
– PAHU has not taken a formal position
since there are pros and cons. Pro is
that it matches CMS' new position and
puts providers on notice that they
must do “Best Practices” to avoid such
an event.? The down side is that the
provider may shift the now
un-reimbursed cost to others. There is
the large issue of creating a climate
with more medical malpractice
lawsuits.
8. HB 2209 (community group insurance)
– PAHU is investigating; the bill
passed committee; the idea is to set
up regional community networks for
smaller employers to share risk. There
are many unanswered questions and PAHU
opposes movement of the bill.
9. HB1551 would allow two or more
employers to pool their employees for
the purpose of purchasing “lower cost
health insurance”. PAHU is concerned
that this is just another Association
Health Plan (AHP) attempt.
10. IBC/Highmark Blues consolidation
legislative process continues to move
forward and the Insurance Department
is researching consolidation questions
in preparation for final legislative
action. PAHU has not taken an official
position (pro or con) on the
consolidation.
11. PAHU opposes creation of a
Consumer Advocate for Insurance,
believing that there should be more
resources directed to fund the
Insurance Department’s consumer
services and consumer liaison
functions. The Department already
serves as a consumer advocate and PA
frankly does not need more
bureaucracy.
12. PAHU does not support raising age
of dependents until age 30, believing
that it will lead to more costs on the
system because of adverse selection.
If enacted, it should require that the
dependent actually be a dependent per
the IRS.
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