House Votes to Expand Health Care Coverage for Uninsured

On March 17, the Pennsylvania House of Representatives approved legislation to expand health insurance options for the uninsured while also extending help to physicians in paying their medical malpractice insurance premiums.

The final tally (118-81) reflected bipartisan support as 17 Republicans joined all Democratic members in voting for the plan.

PHAN supported passage of the bill. Berry Friesen, Public Affairs Manager, described it as “a big step forward in the effort to control the cost of medical care and create a pathway by which low-wage Pennsylvanians can access primary care physicians and preventive health care.”

The House-passed plan faces an uncertain future in the Senate, where leaders have expressed concern about how to finance the plan. Senate leadership also is expected to oppose the way the plan links expansion of health insurance with an extension of state help in paying for doctors’ medical malpractice premiums.

Pennsylvania Access to Basic Care (PA ABC), the new program authorized by the House vote, is projected during 2008-09 to provide health insurance to 81,734 individuals, all of whom are currently uninsured. By the fifth year of the plan (2012-13), the number of newly-insured individuals will grow to 217,640. The plan is expected to cost around $580 million next year and be funded through a combination of redirected state funds; federal matching; individual and employer premiums; and a surplus in an existing health account. About $120 million in revenue still needs to be identified.

The plan adopted by the House will encourage small employers that pay average wages of less than $15 an hour to purchase health insurance through PA ABC. As a condition of participation, such employers will pay one-half the monthly premium, which is expected to be around $155 per employee per month. Employees also will pay a share. Individuals from households with incomes below 200 percent of poverty will be eligible to obtain this coverage at a subsidized rate with premiums ranging from $0-$50 depending on household income. An individual with a household income between 200 percent and 300 percent will pay the full employee share of around $155 a month. To qualify, the employer must have been without a health insurance plan for at least 180 days.

Low-wage employers that currently provide a health plan to their employees will be eligible for state grants to off-set the cost.

Individuals will be able to purchase the health insurance plan. The monthly premium cost will vary between $0 and $311, depending on household income level. To qualify, individuals also will need to show that they have been uninsured for 180 days.

For House Appropriations Committee analysis, click here.

A survey commissioned by the AARP and released March 11th found that 80 percent of Pennsylvanians age 50 and over think it is important to reduce the number of Pennsylvanians without health care coverage. Over 80 percent think employers, the federal government, the state government, and individuals should all contribute to achieving a solution. Two-thirds support an increase in tobacco taxes to fund the state’s share.

Sharon Ward of the Pennsylvania Budget and Policy Center applauded the fact that the House plan approaches health reform in a holistic way. “As amended by the House, SB 1137 addresses both sides of the access problem. It keeps doctors in Pennsylvania and enables more people to afford to visit those doctors. It protects the progress the Commonwealth has made to reduce the burden of medical malpractice premiums while also moving toward an affordable health insurance plan for the uninsured.”