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State Legislation

April 2008

Access to Basic Care (ABC) — Senate Bill 1137

Quick facts: ABC would create low-cost insurance plans in an effort to give all Pennsylvanians access to affordable health coverage.

Senate Bill 1137, which previously focused on medical malpractice insurance, was amended by the House in early December of 2007 to include the Access to Basic Care program (ABC).

ABC would offer free or low-cost basic health insurance to anyone uninsured and to eligible, low-wage, small employers that do not offer health insurance to their employees. ABC would also offer health savings accounts to eligible employees of small businesses.

Under ABC, insurance would be offered at:

• no cost for people earning less than 1.5 times the poverty level;
• $40 a month for those between 1.5 and 1.75 times the poverty level;
• $50 a month for those between 1.75 and 2 times the poverty level;
• the state’s cost, currently estimated at about $311 per month, for those earning up to three times the poverty level.

ABC would also offer tax incentives to eligible small businesses that provide health insurance to employees similar to the state’s insurance plan and larger tax grants to small employers who also offer health insurance to employees’ families.

The ABC program would be partially financed by surplus funds in the state’s MCare fund, which helps doctors pay their malpractice insurance.

The House passed Senate Bill 1137 on March 17, 2008, by a vote of 118 to 81. In the Senate, the bill was initially referred to the Senate Rules and Executive Nomination Committee, and then to the Senate Banking and Insurance Committee. Two hearings on SB 1137 were held by that Committee in June, but the Senate recessed for the summer in early July without a Committee vote on the bill. Health insurance expansion will be a priority issue for both the Administration and Legislature in the Fall.

House Bill 2098

Quick facts: This bill would allow insurance companies to refuse to pay bills for procedures that correct errors the hospital should have prevented, such as infections.

The House Insurance Committee passed Bill 2098 and presented it to the full House, which passed it on April 1, 2008, by a vote of 201 to 2. It has since been referred to the Senate Banking and Insurance Committee. The Senate recessed for the summer without a Committee vote on HB 2098.

The bill would require health plans to withhold payment from providers for preventable, serious, adverse errors. Health care providers would also be prohibited from seeking payment directly from patients for these preventable events.

House Bill 2209

Quick facts: This bill would allow individuals to form a “group” that could purchase more affordable health insurance for its members.

The House Insurance Committee has also passed Bill 2209 and presented it to the full House, where it will now be debated and eventually voted on. The bill would direct the Pennsylvania Insurance Department to establish regional community health networks that would function like associations and be formed for the sole purpose of purchasing health insurance coverage for their membership. While it passed the Insurance Committee, several representatives voted against it, explaining they were concerned about the impact on their local chambers of commerce, which also offer health insurance as part of membership. The House recessed for the summer without voting on HB 2209. It is tentatively set on the House Calendar upon its return on September 15, 2008.