Pennsylvania’s health care debate

    There’s a renewed fight over health care policy in Harrisburg. But what went wrong last time around?

    State lawmakers – who agree on very little – readily admit that the General Assembly failed to make any significant health care fixes during the last legislative session. WHYY investigates what went wrong, and what it means for an issue that grows more pressing by the day.

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    Governor Rendell put Rosemarie Greco in the driver’s seat at his Office of Health Care Reform.

    She says it was tricky to push for major health policy changes while a partisan presidential campaign waged. Greco says Rendell’s health care proposals won national attention, but then in-state politics sunk those plans.

    Greco: There was a sense that certain members of the Legislature did not want to give this governor another win.

    One of Greco’s main goals was to expand Pennsylvania’s state-supported health plan to provide coverage for hundreds of thousands of uninsured people.

    Joe Sebastianelli is president of the Jefferson Health System. He says Rendell’s initial plans were too ambitious. Still, he says, the negotiators came close to an agreement.

    Sebastianelli: It was just that the economic issues began to dominate the discussion over the summer and that then led to a complete stalemate.

    Sebastianelli says the governor’s plan allowed middle-income people to jump from private health insurance to the state-sponsored plan. And that, he says, would have forced hospitals to accept reimbursement rates much lower than rates paid by traditional health insurance plans.

    Greco, who stepped down in December, says she couldn’t convince Sebastianelli – and others – that the program had safeguards to prevent people from gaming the system.

    Greco: No matter how we assured and reassured that we had ways of determining changes in income, changes in jobs, etc. What we were told was: Well, rich people will be able to get this kind of coverage.

    Greco’s former deputy, Ann Torregrossa, now runs the Office of Health Care Reform.

    Torregrossa: Senate Republicans, I think, came out with their proposal quite late.

    Torregrossa says the GOP had at least three ideas worth considering: expanding support for community health clinics; providing transitional health insurance for small business workers who are between jobs; and letting adult children remain on their parents’ health insurance longer.

    Torregrossa says negotiators ran out of time, but Rendell’s Policy Secretary Donna Cooper says Senate Republicans just ran out the clock.

    Cooper: So we began to whittle away the package in hopes that it would be a modest enough expansion that it would be impossible for the Senate not to act. But I think we underestimated the Senate’s resolve in making sure this issue didn’t come to a vote.

    The chair of the Senate public health committee doesn’t agree with Cooper’s take. Delaware County Republican Edwin Erickson says he tried to restart discussions with the Democrats as the legislative session came to an end.

    Erickson: Initially they said: “Yeah, well, let’s do this and then all of a sudden that just ended. And they wouldn’t even come to a meeting. So, you know, hey, what can I tell you?

    The head the state’s small business lobby says Governor Rendell stumbled when he boxed out manufacturers and others who create jobs. Kevin Shivers is state director of the National Federation of Independent Business.

    Shivers: They chose to fill the table only with those individuals who agreed with them. You know the governor in his first plan introduced a payroll tax that essentially would effect 50 percent of small business owners in Pennsylvania.

    Shivers says there’s a better way move government policy forward. He wants a very public process like the one used to evaluate the proposed merger between the state’s two largest health insurance companies.

    Some experts say the budget crisis will make it harder to broker a health care deal, but Ann Torregrossa, Governor Rendell’s point person on the issue, is still optimistic.

    Torregrossa: So hopefully these more dire times will bring us to the table and allow some of these things that have not happened so far to happen.

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