Upcoming Reforms In Pennsylvania's Health Insurance Program
Upcoming Reforms In Pennsylvania's Health Insurance Program
Governor Ed Rendell has recently introduced his program to reform health care in Pennsylvania. This proposed program for health insurance reform in Pennsylvania, entitled Prescription for Pennsylvania, still needs to be approved by the legislature. If it is approved, it will certainly bring changes for PA residents. Governor Rendell's overall objective will result in health care for everyone in the State, including about 767,000 who currently do no have any health insurance coverage. Here are some of the high level means in which his program will benefit residents in Pennsylvania.
1. Affordable Insurance For All
A new program which is part of the Prescription for Pennsylvania is called CAP, which stands for "Covering All Pennsylvanians." By this, Rendell intends to bring affordable health insurance to everyone in PA, especially those who make less than the State's average income of $39,000. There are two target areas that this program is seeking to provide insurance for. They include those who are:
Employed individuals who do not have health insurance
Small businesses owners who do not have health insurance
2. Employed Individuals Who Do Not Have Health Insurance
Governor Rendell's own goal for those who are employed but have no insurance, but limited to those who make at least 300% of the poverty level of income, is to be able to provide health care coverage for around $280 per month. Apparently this is the actual cost of providing this policy that his counsel has determined. There are presently several insurance carriers offering health insurance for this amount or less in Pennsylvania.
3. Small Business Owners Who Do Not Have Health Insurance
By providing health insurance for small businesses, CAP will help employees and employers meet their health needs. It will also encourage business growth in Pennsylvania. If the business chooses to join the CAP program, the employee would be responsible for between $10 and $70 each month while the employer will pay about $130 for each employee.
4. Program To Reduce Medical Costs Will Make It More Affordable
Several areas in the new program are targeted to curb overgrown and unnecessary health care costs. These targeted areas will help reduce billions of dollars spent each year and will help reduce the overall cost, making a health insurance plan more affordable. Here are some of the features that have been specifically mentioned:
A. Examination of Services Performed - Certain areas are being examined to potentially reduce current medical care costs such as reducing the length of hospital stays in order to prevent things like hospital infections. Another targeted problem will be those hospital stays that could have been prevented by better personal self-care or better physician services in the first place, such as treatment among people who have diabetes, asthma, and other various medical conditions. This also includes scaling back on certain procedures and tests that may be unnecessary.
B. Reduce Medical Costs By Enlarging Services. The annual cost of providing health care is billions of dollars. The Governor is looking to reduce this figure by cutting out unnecessary expenditures in order to lower costs of health insurance in Pennsylvania. By expanding medical facilities hours of operations to include evening hours and weekends, he believes there will be less of a need to use emergency rooms for everyday medical needs. Furthermore, Rendell hopes that by bringing everyone into the health insurance program, the overall costs of healthcare in Pennsylvania will decline.
C. Other Changes That Will Benefit Many - Other additional changes in the health insurance in PA program include:
Allowing Nurses To Perform More Services:
Rendell proposes the utilization of medical attendants like nurses and possibly dental technicians in a greater capacity as they are trained to do more than they generally are permitted to do. One proposed change is the provision of prescriptions during the birthing process. Mid-wives and nurse practitioners already deliver as much as 10% of newborn population in PA, and this would be the natural progression of their services into this arena.
Additionally, nurses in a nurse-controlled medical facility may not be permitted to treat infected toenails, remove moles, or stitch wounds. In fact, many nurses regularly perform these types of treatments in a doctor-controlled facility. By allowing them to perform these medical functions on a statewide basis and not by facility type, health care costs will be reduced as doctors will instead perform functions that are more geared to their specialized training.
Adapting nurse care in such areas as these would certainly enable health insurance costs to be reduced as nurses do not charge fees as high as doctor do for their services.
Reducing Costs Through Rebates:
For small business plans, Rendell proposes a rebate if an employer's medical costs for their group plan uses less than 75% of the collected premiums. The insurer would then provide a rebate to each of the employees. For those years in which expenses are lower than expected, costs would be less for the employer and employee. It is uncertain how the insurers would fund claims for the groups whose claims exceed 200% or even 500% of their premiums. If this is done on an overall loss ratio basis, it would be of great benefit to employers.
All of these changes will soon positively impact health insurance in Pennsylvania. Many people will surely be given better healthcare. The Prescription for Pennsylvania may really be a wonderful plan. Only time will tell. By: Clelland Green Article Source: http://www.ArticleDashboard.com Clelland Green makes understanding insurance topics and plans easy to help consumers make the best insurance choices for their situation and budget. To learn more or to get an online insurance quote, visit this site now: Affordable Health Insurance Quotes.
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