The proposed legislation would put in place an insurance plan, Pennsylvania Access to Basic Care, that if passed could cover 90,000 adult Pennsylvanians by 2009.
By 2013, proponents estimate that more than 270,000 of about 747,000 uninsured adults in the state could obtain coverage through private insurers, said Rep. Eugene DePasquale, D-York City.
DePasquale and state Secretary of Health Dr. Calvin Johnson discussed the plan earlier this week as part of Cover the Uninsured Week, a project of the
Robert Wood Johnson Foundation aimed at raising awareness about Americans who do not have health insurance.
The New Jersey-based nonprofit foundation seeks a national solution, but DePasquale and Johnson said a federal fix is likely decades away. The proposed state insurance plan stems from Gov. Ed Rendell's 2007 health care proposal, "Cover all Pennsylvanians."
The bill for the current plan has passed through the state House and now awaits action in the Senate Rules and Executive Nominations Committee.
Whether it gets out for a full Senate vote is unclear. The approval process will have to restart if it doesn't get to Gov. Ed Rendell's desk by year-end.
"We'll see what the Senate does," DePasquale said.
Concern: Nathan Benefield of the Commonwealth Foundation for Public Policy Alternatives says the current plan does not address the root problem of rising health care costs.
The Commonwealth Foundation describes itself as a nonprofit, nonpartisan research group that analyzes public policy. Benefield said state lawmakers should reduce state mandates for one-size-fits-all insurance.
The state requires insurers to cover more than 80 services such as alcoholism services, diabetes management and mammograms regardless of whether the insured needs or wants that coverage.
That drives up premiums for everyone, Benefield said, because insurers are forced to plan for those expenses even if the insured never uses them.
"While those might be good things, I as a consumer should be able to choose the coverage I have," Benefield said.
He also asserts that residents should be able to buy out-of-state insurance that costs less but provides similar coverage. Health savings accounts or health care tax credits also are worth investigating, he said. Employers could contribute to health savings accounts, as could the account bearer.
Cost: The plan stalled in the Senate would cost about $580 million next year and would be funded by a combination of redirected state funds, federal matching and private dollars. But funding comes up about $120 million shy.
Rendell had proposed an increase in the state's cigarette tax and, for the first time, a state tax on cigars and smokeless tobacco to cover that gap, said Amy Kelchner, spokeswoman in the Governor's Office of Health Care Reform.
Under the current plan, lawmakers are leaving the door open to using the same options or finding money somewhere else, she said.
Premiums would be based on annual income with subsidies offered by the state to people earning up to 300 percent of the federal poverty guideline. This year, the poverty guideline is $10,400 annually for an individual and $21,200 for a family of four, according to the U.S. Department of Health and Human Services.
The health department estimates that 58 percent of adults considered eligible for plan earn below 200 percent of the poverty guideline -- $20,800 per individual and $42,400 for a family of four. Those earning more than 300 percent of the federal poverty guideline could buy in, paying the full monthly premium of $311.
-- Reach Kathy Stevens at 505-5437 or firstname.lastname@example.org.