Rendell says he will agree to scaled-back health care plan

Published: October 7, 2008
Capitolwire

HARRISBURG (Oct. 7) – Gov. Ed Rendell says he will agree to a scaled-back plan to extend health care coverage to uninsured Pennsylvanians in the hopes of enacting legislation before the Senate recesses for the year on Wednesday.

Rendell signaled to Senate GOP leaders Tuesday that he is willing to accept a health care plan that only insures those currently on adultBasic and the 120,000 uninsured Pennsylvanians on the adultBasic waiting list.

Such a compromise would insure 167,000 people, said Amy Kelchner, a spokeswoman for the Governor’s Office of Health Care Reform. That’s much less than earlier Rendell proposals that would have extended health care to anywhere from 240,000 to 270,000 uninsured Pennsylvanians.

Rosemarie Greco, who directs the Governor’s Office of Health Care Reform, wrote in a letter to Senate Republican leaders Tuesday: “While we believe we have put forward a responsible and financially sustainable plan to increase coverage to at least 100,000 more people than are currently on the adultBasic waiting list, we will agree to a compromise that provides coverage to the current number of people enrolled in adultBasic and to the current number of people on the adultBasic waiting list as you propose."

The letter was addressed to Senate Majority Leader Dominic Pileggi, R-Delaware, Senate Public Health and Welfare Committee Chairman Ted Erickson, R-Delaware, and Senate Banking and Insurance Committee Chairman Don White, R-Indiana.

Erik Arneson, a spokesman for Pileggi, responded by e-mail: “Discussions are continuing on health care issues.”

Neither Erickson nor White could be immediately reached for comment.

Greco wrote that the scaled-back health care proposal would be acceptable as long as the benefit package included prescription drug coverage and limited behavioral health benefits for all enrollees.

Administration officials say those benefits must be included in order for the program to qualify for federal Medicaid dollars. The administration has been in contact with federal Medicaid officials about obtaining funding for the program, but Senate GOP staff have questioned whether those federal dollars would be made available for such a program.

Greco also wrote that any compromise would need to include prior proposals from the governor on medical provider reimbursement rates, which are less generous than current adultBasic rates. Kelchner said premium estimates are based on reimbursement rates that track Medical Assistance reimbursement rates, with a 21-percent boost on payments for outpatient physician services and a 7-percent boost for inpatient hospital services.

Greco wrote that the administration would also insist on a plan to allow the Department of Public Welfare to manage the pharmacy benefit in the new program.

By allowing the department to manage that benefit, the state could obtain rebates on certain prescriptions that private pharmacy managers cannot, Rendell administration officials say. Lawmakers, however, have balked at allowing the department to manage the prescription drug benefit for more Medical Assistance patients in recent years, questioning its capacity to do so.

When asked how quickly the administration could roll out the health care program, if enacted, Kelchner said that the state would “work with the Senate" on that issue, "but we have the capacity to add at least 40,000 more to the rolls of the insured by the end of this fiscal year,” in addition to the 50,000 people already on adultBasic.

Kelchner said the waiting list for adultBasic had ballooned to 120,000, with 7,000 people signing on in just the last month.

The compromise put forward by the governor would also continue a subsidy for doctors who have to purchase $500,000 in medical malpractice coverage through the state-run MCARE Fund.

The subsidy would be continued for five years, and at the same time, the state would phase out the MCARE Fund, eventually requiring doctors to purchase all $1 million in required coverage on the private market. That phase-out would begin in 2010, with the $500,000 in MCARE coverage decreasing by $100,000 every year, over the five-year period.

Rendell has refused to continue the MCARE subsidy without a health care program. Senate Republicans, meanwhile, have tied legislation to reauthorize the Pennsylvania Health Care Cost Containment Council, a health data collection agency that will expire if the Legislature doesn’t extend its legal authorization, to the extension of the MCARE subsidy.