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AFFORDABILITY AND AVAILABILITY FOR EMPLOYERS & INDIVIDUALS 

To be competitive, Pennsylvania citizens and our businesses must have the ability to access affordable health care.  According to recent data, more than 90 percent of Pennsylvanians are  covered by health care insurance.  For many, their insurance is purchased in whole or in part by their current or former employer, or spouse’s employer.  Mandated health care benefits, excessive medical liability claims, and other factors combine to drive health care cost increases at alarming rates. Pennsylvania’s business community recommends the following steps: 

Adopt Basic Health Plans
Allowing small businesses to pool together to purchase health insurance will help increase bargaining power and decrease administrative costs, which will increase coverage.  These plans would provide additional insurance options for small business and ultimately lead to more competition in the marketplace.  Competition leads to better pricing and more choices. 

Related Legislation:
HB 265:  Basic health plans/small group plans

Allow Association Health Plans
Permit employers and self-employed persons to pool together for health insurance to spread risks and lower costs.  An association health plan (AHP) is insurance coverage that is offered to members of an association and is one way to address the problem of the uninsured, by offering an alternative for small employers who currently cannot afford to provide health insurance benefits to their employees. 

Related Legislation:
HB 318:   Group health insurance plans

Oppose Health Care Mandates
Oppose to the expansion of mandated benefits, unless sufficient evidence exists demonstrating that the benefits of the mandate clearly outweigh its costs. 

Related Legislation:
SB 193: Mandates infertility treatment
SB 214: Expiration of certain mandates
SB 215: Expiration of certain mandates
SB 427: Mandates prescription contraceptives
SB 429: Mandates coverage of eating disorder treatments
SB 438: Hospital patient protection act (includes mandating # of nurses, etc.)
HB 414: Mandates prescription contraceptives
HB 432: Mandates diabetic supplies
HB 508: Insurance coverage for cancer clinical trials
HB 532: Mandates coverage of general anasthesia
HB 783: Mandates reimbursement for prosthetic devices 

Promote Health Savings Accounts
Adopt policies that increase incentives for employers to create and maintain Health Savings Accounts (HSAs) and Health Reimbursement Accounts (HRAs) that would empower employees to take more ownership of their health care and health benefits. 

Related Legislation:
SB 212:  HSA Tax Credit
SB 213:  HSA for government workers

Ensure Access to Innovative Therapy While Maintaining Cost-Effectiveness
Patients should have access to the most appropriate treatments including innovative diagnostic tests and therapies. Reasonable public policy should provide assurance to health care purchasers, however, of treatment efficacy and long-term cost-effectiveness. 

Require Fair Health Care Provider Contracting 
Require fair health insurance contracting so that there is a level playing field between health insurers and physicians and hospitals to ensure access and reduce administrative costs. 

Related Legislation:
SB 335:  Health Care Provider Contracting

Adopt Quality Measures
Pennsylvania must create, adopt and use health care quality measures that are based on verifiable clinical standards.  The Pennsylvania Health Care Cost Containment Council (PAHC4) is important to gathering, analyzing, and reporting health care quality and cost data.  Pennsylvania must continue to make this data readily available to insurers, employers, individual health care consumers so that they can make informed choices regarding their health care treatment. 

Related Legislation:
HB 614: Quality measures for long-term care 

Expand Health Information Technology
Expand the use of health information technology (e.g. electronic medical records) as a means to reduce the cost of treatment and improve patient safety.  Moreover, new physicians trained in the use of these technologies will find Pennsylvania a more attractive state in which to practice. 

Related Legislation:
HB 341:   Health IT Expansion
HB 863:   Health IT grants and loans


Utilize Best Practices
Use best practices for health insurers and providers that help eliminate excessive and unnecessary costs.
 

Enact Malpractice Reform
Adopt legal reforms based on fairness, common sense and personal responsibility that will allow for a stable and predictable insurance system for providers.  This will reduce costs and help to recruit new physicians to Pennsylvania. 

Retire the Mcare to pay its Fair Share
Retire the Mcare (Medical Care Availability and Reduction of Error) fund and its unfunded liabilities.  New physicians should not have to be burdened with the possibility of paying the unfunded liabilities of the Mcare fund. 

Related Legislation:
SB 219:  Mcare phase-out
HB 299 Mcare non-economic losses cap
HB 732:  Mcare Fund 

Increase Physicians in Underserved Areas
Rural and inner-city Pennsylvania suffer from shortages of general practitioners and some specialties.  Insufficient numbers of doctors reduces access to health care and can increase the cost of health care.   Pennsylvania should offer incentives to encourage physicians to practice in the state’s medically underserved areas. 

Related Legislation:
SB 278:   Physician retention/physicians in underserved areas
SB 735:   Physician Loan Forgiveness
SB 738:   Medical Education Loan Assistance Program
HB 306  Physician retention/physicians in underserved areas

Doctor-Patient Relationships
Government and health insurance practices should protect the patient-doctor relationship so that patients understand and clearly participate in their health care and respect the professional autonomy and independence of their physician. 

Related Legislation:
HB 383:  Freedom of Conscience bill
HB 495:  Benevolent Gesture

SB 565:  Benevolent Gesture

Limit Medicaid to its Original Purpose
Medicaid’s core purpose is to serve needy, low-income individuals.  Eligibility and benefits rules have been expanded well beyond Federal mandates, thereby greatly increasing costs.  Public policy should promote individual responsibility and planning for long-term care needs.  Programs and benefits for which the costs outweigh the benefits should be eliminated. 

Related Legislation:
HB 732:  Providing medical assistance to inmates 

Medicaid Should Pay its Way; Not Shift Costs
Medicaid should pay its fair share of costs when making payments to health providers so that costs to private insurance are not passed on to employers and individuals who pay the premiums.

 


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Top Issues

The goal of Pennsylvania policymakers should be to make it the smart business decision for employers to locate, expand, and hire here in this commonwealth rather than in one of our competitor states. Likewise, the goal of federal policymakers ought to be to optimize conditions for economic growth in the United States so American businesses can compete worldwide. This means we must restrain state spending, enact pro-growth business tax relief, provide limits on lawsuit abuse, improve the regulatory climate, and ensure we have a trained workforce. Our state government cannot tax-and-spend the way to good fortune for all; but we can grow the private sector by attracting new business investments and expanding the tax base, then prosperity will surely follow.

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