Rendell’s plan deserves support
In December, Gov. Ed Rendell asked the Legislature to adopt his revised “Cover All Pennsylvanians” health-insurance plan. This was just before the Legislature was to recess for the year and we said, “Slow down!” Given the complexity of what the Governor’s plan, the matter deserved careful consideration, not drive-by adoption. Now, a month later, the second half of this legislative session is under way and the Gov. Rendell’s plan is back in the spotlight. Last year, we had reservations about how the state would pay for the very important goal of helping part-time and low-wage employees get health coverage. The Governor’s current plan addresses those concerns. With one relatively small question about what will happen in the out-years of Gov. Rendell’s 10-year program, “Cover All Pennsylvanians” deserves to be enacted.
The big change that the governor made at the end of last year was to remove a payroll tax that would have collected funds from employers to cover almost 800,000 uninsured adults in Pennsylvania. Instead, he would raise the cigarette tax by 10 cents a pack and enact a new tax on cigars, chewing tobacco and snuff, products whose sale is taxed in every other state. Last year, 71 percent of Pennsylvanians in a Quinnipiac University poll said they favor raising tobacco taxes to pay for health care.
He also would use the growing surplus in Mcare, the fund Pennsylvania created in 2003 to help physicians with medical malpractice insurance premiums, and this is the most controversial part of the plan. However, we think that close examination of the details reveals that it is reasonable, fair to physicians and in the best interests of the most Pennsylvanians.
The Mcare fund has paid out about $1 billion to physicians and now has a surplus of $414 million. That surplus is growing, partly because payouts from the fund in 2007 were half what they were in 2003. Mr. Rendell would use a portion of it, in varying annual amounts, over the next 10 years, a total of $260 million or so, for “Cover All Pennsylvanians.”
One beauty of expanding state-sponsored coverage is that 29,000 people are on waiting lists for AdultBasic, the existing state program for working adults whose employers don’t provide, and they can’t afford, insurance. The waiting lists include 3,572 from Lehigh County, 2,034 from Northampton County and 683 from Carbon County, to mention just a few in this region. The expansion the governor proposes would wipe out those waiting lists.
Opponents have criticized Mr. Rendell for linking extension of the Mcare fund to spending more on covering low-wage earners. But, it makes sense to put a 10-year program in place just for the stability it would provide. Every year, the Legislature and the executive fight over the details of extending Mcare. Draining the politics out of that annual debate is a good thing.
Gov. Rendell raised the health insurance rhetoric a notch earlier this week, warning of political consequences for those who don’t help uninsured people. Maybe, maybe not, although health care certainly is much on the minds of presidential candidates from both parties this season. The Governor also made another good point about raising the tobacco taxes. The Legislature found the courage to raise those taxes in 2002 when it created the Mcare fund to help physicians. Now, in order to help people without health insurance, it should do it again.