Pa. can lead by example | Rendell revises plan for uninsured citizens

Pittsburgh Post-Gazette

Last year, Gov. Ed Rendell devised a way to provide coverage for Pennsylvanians who lack health insurance, and now he’s found a better way to pay for it.

Right now, 767,000 state residents do not have access to health insurance. The vast majority of them are working, many of them piecing together two or three jobs so they can take care of their families, but part-time work doesn’t usually bring health benefits.

When Rendell held a news conference last week, he was surrounded by a couple dozen citizens, all of them lacking insurance and all of them with pre-existing medical conditions that mean they don’t have much chance of getting it without some help.

The help that the governor has been proposing in his Cover All Pennsylvanians plan is an attempt to do what the federal government has failed to accomplish, and the revamped version is an improvement over his original initiative.

Where before he wanted to fund part of the program with a tax on employers who don’t provide health insurance, Rendell is now looking to tap a surplus in a state fund that helps doctors pay their medical malpractice insurance. In addition, as before, the governor is calling for an increase in the tax on cigarettes and for a new tax on cigars and smokeless tobacco.

Let’s deal with the taxes first, even though that’s the last thing most elected officials will want to touch. The Rendell administration has suggested a tax of 36 cents per unit on cigars, snuff, chew and any other tobacco that’s not a cigarette. Pennsylvania is the only state that does not tax tobacco products beyond cigarettes, and we can think of no rational basis for the exclusions.

The governor is also seeking a 10-cent increase in the cigarette tax, which now is $1.35 per pack. In a Quinnipiac University poll last year, 71 percent of Pennsylvanians said they supported raising the cigarette tax to help pay for health insurance. That’s a number that legislators should not ignore.

In 2003, when the state was worried about its ability to retain physicians as their malpractice rates escalated, the Legislature raised the cigarette tax. Twenty-five cents a pack fuels a fund that helps doctors pay for malpractice insurance.

In the past five years, claims paid out have fallen by about 18 percent a year due to fewer malpractice lawsuits and smaller judgments.

There’s now a $414 million reserve in the fund.

Rendell wants to use some of it – the amount will vary by year – for Cover All Pennsylvanians, and his 10-year plan promises to keep the help coming for doctors at the same time. The first claim on the funds would continue to be the doctors’ insurance subsidies. The financial model for the program is a conservative one, not a risky venture that is likely to imperil the doctors’ assistance program.

And the proposal would cement the program in place for a decade, rather than having it come up for renewal every year.

Republicans who are against the plan consider it a new government entitlement and instead propose measures including tax credits and incentives for businesses that offer health savings accounts and wellness programs.

But Rendell’s initiative is a more direct remedy for an ailment that afflicts Pennsylvania and the rest of the nation.

A New York Times/CBS News poll last year found the majority of Americans said the federal government should guarantee health insurance to every citizen and they said they were willing to pay higher taxes to see that happen. But no national solution has been enacted.

Pennsylvania now has an opportunity to help its uninsured citizens and to lead the nation by example. Democratic state Sen. Vincent Hughes of Philadelphia last week summed up the situation with an adage directed at legislators who won’t support the proposal: “If you’re not part of the solution, you’re part of the problem.�

Well said.
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