House Passes Mcare and Health Care Reform Plan
The Pennsylvania House of Representatives passed a health care reform plan that would extend Mcare abatement, phase out the Mcare Fund, and expand state-subsidized health care.
The plan—passed by the House on March 17—has increased the Pennsylvania Medical Society’s already high concerns about Pennsylvania’s problems with physician recruitment and retention.
The plan was introduced as an amendment, sponsored by House Democratic Policy Committee Chairman Todd Eachus (D-Luzerne), to
Senate Bill 1137, a measure to extend Mcare abatement into 2008 that was passed by the Senate and then amended by the House last fall.
The House passed the amendment on a 114-81 vote on Wednesday, March 12, and the bill by a 118-81 vote on Monday, March 17. The bill now goes to the Senate, where it faces an uncertain future.
In a press release March 18, Gov. Ed Rendell repeated his opposition to signing a bill to extend Mcare abatement for 2008 if “meaningful” progress isn’t made on a state-subsidized health care plan.
Society’s concerns
The Society supports many elements of the plan—including offering health insurance coverage to the uninsured—but has a number of important concerns, as outlined in a
statement from the Society's Executive Committee.
The Society is concerned that, without critical amendments, the plan would further deter physician recruitment and retention—and therefore threaten access to care. While offering short-term relief through 2008 abatement, it would not guarantee long-term stabilization of the physician practice environment.
In addition, the plan would continue the “linkage” between the Mcare issue and the coverage for uninsured issue. Because there is virtually no likelihood that the complex insurance proposal can be resolved by March 31, passage of the bill now forces all physicians to make full, unabated Mcare payments by March 31.
The Society is concerned that the bill would deter physician recruitment and retention because it mandates physician participation in state-run insurance plans without essential reimbursement and participation information, does not guarantee a funding stream for abatement, and does not include a provision to stabilize physician’ premiums as primary limits increase during the 10-year Mcare Fund phase-out.
Health insurance plan details
The state-subsidized health insurance plan, called Pennsylvania Access to Basic Care (PA ABC), would extend health insurance coverage to 272,600 uninsured Pennsylvanians within five years, at a cost of about $1.1 billion annually by 2012-13.
State residents between the ages of 19 and 64 who meet the income requirements and have gone six months without insurance would be eligible. Those earning up to 200 percent of the federal poverty level—or $42,000 for a family of four—would receive free coverage. Those earning up to 300 percent of the poverty level could buy coverage at full cost, or about $311 a month.
The plan would offer more coverage than the state's adultBasic health insurance plan, including prescription drugs, wellness care, chronic disease management, and behavioral health. The Insurance Department would decide the scope of coverage and co-pays.
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Last Updated: 8/14/2008