FOR IMMEDIATE RELEASE:
Jan. 17, 2007
GOVERNOR RENDELL UNVEILS HISTORIC
ePRESCRIPTION FOR PENNSYLVANIAf TO PROVIDE ACCESS TO AFFORDABLE, QUALITY
HEALTH CARE FOR ALL PENNSYLVANIANS
eCOVER ALL
PENNSYLVANIANSf WILL INSURE SMALL BUSINESS, UNINSURED
HARRISBURG — Building on his successful initiatives
to expand access to health care, including Cover All Kids and
PACE/PACENET, Governor Edward G. Rendell today offered a sweeping and bold
gPrescription for Pennsylvaniah to increase access to affordable health
care coverage for all Pennsylvanians, improve the quality of care, and
bring health care costs under control for employers and employees.
gWe can no longer stand by while health care costs spiral out of
control, leaving some 767,000 adult Pennsylvanians without the basic
health care they need. Itfs creating a drag on our economy,h Governor
Rendell said. gIt is no longer a question of whether we can afford to act.
The cost of inaction is far greater in terms of individual health
consequences and from the increasing burden on taxpayers.
gEvery year, Pennsylvania businesses, consumers and taxpayers pay at
least $7.6 billion for unnecessary and avoidable health care costs. That
is money that isnft improving the quality of care we receive, nor making
Pennsylvanians healthier. It doesnft make sense. We should be redirecting
that money to fix our broken health care system.h
Included in the $7.6 billion is more than $6.2 billion for health
care services that could be avoided, including additional hospital days
due to potentially avoidable hospital acquired infections;
hospitalizations that could have been avoided with better care for
patients with chronic diseases such as diabetes and asthma; and additional
days of hospital care due to readmissions for complications, infections
and certain medical errors.
Pennsylvanians pay another $1.4 billion to help cover the costs of
treating people who are uninsured and underinsured.
gIt is a tremendous deterrent for businesses that are considering
locating in Pennsylvania to know that in addition to paying for their own
employeesf health coverage, they will be subsidizing the costs of the
uninsured,h the Governor said. gI have no doubt that most business owners,
no matter what their size, would like to offer coverage to their
employees, but they canft because itfs just too expensive. This
Prescription for Pennsylvania will make it easier for businesses to offer
coverage for their employees by reducing costs.h
Cover All Pennsylvanians
To improve access to health care by lowering costs, Governor
Rendellfs proposal calls for the creation of Cover All Pennsylvanians
(CAP), a program offering affordable basic health coverage to small
businesses and the uninsured through the private insurance market.
gCover All Pennsylvanians focuses urgent help where it is needed the
most – on small businesses and on the uninsured,h Governor Rendell said.
gThe majority of uninsured adults in Pennsylvania are employed, and most
of the uninsured workers hold full-time jobs. By bringing down the cost of
coverage, we can make it easier for businesses and employees to obtain
desperately needed health coverage.h
Businesses may participate in CAP if they have not offered health
care for their employees in the past six months, if they have fewer than
50 employees and if, on average, those employees earn less than the state
average annual wage (approximately $39,000). Businesses that choose to
join the program will pay approximately $130-per-employee/month and their
employees will pay on a sliding scale, ranging from $10 to $70, depending
on income.
Governor Rendell said all uninsured Pennsylvanians – no matter the
size of their employer – will be able to purchase affordable health
insurance through CAP. Every uninsured adult who earns more than 300
percent of the federal poverty level can participate in CAP by paying the
full cost of the premium, which will be approximately $280 per
month.
Uninsured adults who earn less than 300 percent of the federal
poverty level and employees of small businesses whose average wages are
lower than the Pennsylvania average will get help paying CAP premiums
through discounts and subsidies. For example, a family of four who earns
up to $60,000 a year will be eligible for assistance.
The Governor said he plans to phase in a mandate requiring health
insurance for those with incomes more than 300 percent of the federal
poverty level ($60,000 for a family of four) and require that full-time,
four-year college students and graduate students have insurance coverage.
He said if more people are covered, the cost of health care will be lower
for everyone.
He also said that there would be a fair-share assessment on all
companies that do not insure their employees. That assessment would be
used to help pay for the cost of the CAP program. In the first year of the
assessment, employers with fewer than 50 employees would be exempt.
Access
To further enhance access to health care, the Prescription for
Pennsylvania will enable nurses, advanced nurse practitioners, midwives,
physician assistants, pharmacists, dental hygienists and other licensed
health care providers to practice to the fullest extent of their training
and skills.
Prescription for Pennsylvania also promotes incentives for health
care providers who offer services in the evenings and on weekends, which
will help to discourage consumers from seeking emergency room treatment
for routine medical concerns.
gPennsylvanians, statistically, are more likely than the average
American to go to the emergency room. This is often the most expensive
setting in which to receive treatment,h Governor Rendell said. gMy plan
will promote non-emergency settings for non-emergency care.h
Quality
To improve the quality of health care, the Prescription for
Pennsylvania calls for significant reforms that will increase the
accountability of everyone in the health care system: consumers, hospitals
and other care providers. The initiative will focus on improving patient
safety by eliminating hospital-acquired infections and targeting avoidable
medical errors.
Pennsylvania will also promote the use of a successful,
nationally-proven model that manages treatment for chronic conditions such
as heart and lung disease, diabetes and asthma. Even though 75 percent of
health care costs can be traced to the 25 percent of patients with chronic
disease, these Pennsylvanians received only 56 percent of the care they
need.
The Prescription for Pennsylvania includes more effective regulation
of the insurance industry to protect small businesses and individuals from
extraordinary spikes in health care premiums. It will implement adjusted
community rating, which prohibits using certain demographic
characteristics such as health status and gender in setting rates.
The plan also updates decades-old hospital regulations to require
state-of-the-art patient safety and electronic health records, initiatives
that will improve the quality of care patients receive and, in turn, drive
down costs.
In addition, Governor Rendellfs plan promotes a common-sense payment
system that rewards wellness and stops paying for unnecessary or
ineffective medical services. And to help all Pennsylvanians stay healthy,
the plan includes consumer incentives that reward healthy
lifestyles.
gThe health care costs related to tobacco use and adult obesity in
Pennsylvania totaled more than $9 billion, an enormous economic burden,h
the Governor said. gSecond-hand smoke is responsible for the death of as
many as 3,000 Pennsylvania nonsmokers every year. That is why Prescription
for Pennsylvania will make all Pennsylvania workplaces, restaurants and
bars smoke free.h
gGovernment alone cannot – and should not – attempt to solve every
problem facing our statefs health care system,h Governor Rendell said.
gHowever, simply maintaining the status quo will needlessly cost billions
of dollars and countless lives.h
Specific components of Governor Rendellfs initiative will require
legislative and federal approval. If the necessary approvals are timely,
the CAP program is expected to begin operating in January 2008. The
financial aspects of the plan will be further detailed when Governor
Rendell announces his budget proposal for the 2007-08 state fiscal year in
early February.
For more information on Governor Rendellfs Prescription for
Pennsylvania and the proposed Cover All Pennsylvanians program, visit
http://www.gohcr.state.pa.us/.