Government Relations Update – October 4, 2011

Pennsylvania Issues

Legislation

• H.B. 1880:  Professional Nurse Staffing Standards. On September 29, 2011, State Representative William F. Adolph, Jr. (R-Delaware) introduced legislation which would require each Pennsylvania hospital to develop, implement and monitor a professional nurse staffing plan for each hospital unit based on patient acuity, patient volumes, the experience of the nursing staff and support services available to the nurses.  The plan would be developed by a professional nurse staffing committee, and the majority of the committee members would be professional nurses currently providing direct patient care in the hospital selected by their peers to serve on the committee.   Hospital and nursing administration and the elected chairperson of the professional nurse staffing committee would determine other staff to be represented on the committee.  According to Representative Adolph, the legislation would improve quality and patient outcomes.  Representatives Julie Harhart (R-Lehigh, Northampton ) and Justin Simmons (R-Lehigh, Northampton ) serve as co-sponsors of the bill, which has been referred to the House Committee on Health.  The Pennsylvania State Nurses Association, the American Nurses Association and other regional nursing associations support the bill.  The Hospital Association of Pennsylvania (HAP) opposes the bill since it would create new administrative burdens on hospitals while limiting their ability to adjust staffing to meet changing patient needs.  We are communicating our opposition to the bill to our local legislators. 
• House Resolution 407:  Patient Safety Authority.  On September 27, 2011, State Representative Phyllis Mundy (D-Luzerne) introduced a resolution that would require the House Legislative Budget and Finance Committee (LBFC) to study the Pennsylvania Patient Safety Authority (PSA) in order to determine if: (1) the PSA is achieving its desired effect of increased patient safety and better health outcomes; and (2) funds dedicated to the PSA are being well spent.  The PSA receives $5 million annually through surcharges placed on medical facility licensing fees from the Patient Safety Trust Fund.   The LBFC has not reviewed the PSA since its creation by the General Assembly in 2002. HAP is reviewing the resolution. 

Advocacy

• Health Insurance Exchanges:  The Federal healthcare reform law, known as the Patient Protection and Affordable Care Act (PPACA), creates statewide health insurance exchanges by 2014 for individuals and small businesses to compare health insurance plans and rates.  If a state fails to create an exchange in accordance with PPACA, the Federal government will design one for it.  Pennsylvania previously accepted about $3.4 million from the Federal government to explore the feasibility of creating an exchange.   The House Insurance Committee is currently considering the framework for a statewide exchange and has scheduled a public hearing on the topic for October 5, 2011.   HAP is working to ensure that hospitals retain the right to freely negotiate with insurance providers participating in the exchange to ensure competitive reimbursement rates.  Otherwise, a system could be created in which the rates are not adequate to provide access to quality care.

Miscellaneous

• Pennsylvania General Election:  Pennsylvania municipal elections will take place on November 8, 2011.  State Representative Doug Reichley (R-Berks, Lehigh) and Lehigh County Commissioner Dan McCarthy are the candidates for Judge on the Lehigh County Court of Common Pleas.   Incumbents Peter Schweyer (D) and Jeanette Eichenwald (D) are running together with former City Controller Frank Concannon (D), Steven Ramos (R), Eric Weiss (R) and Bob Toth (R) for three (3) seats on Allentown City Council. 

Federal Issues

Advocacy

• National Deficit Reduction Plan:  As previously reported, Congress passed the much anticipated debt ceiling relief bill on August 2, 2011, which will raise the nation’s debt ceiling in several steps until 2013 and reduce the federal budget by about $2.1 trillion over the next 10 years.  The first stage of the bill requires $917 billion in federal spending reductions over the next ten years in exchange for a $900 billion increase in the national debt ceiling.  The second stage of the bill requires a special joint committee of Congress to recommend by late November an additional $1.2 trillion to $1.5 trillion in additional spending cuts to be implemented over ten years.  If the committee’s recommendations are enacted by late December, then the debt ceiling can be raised by an amount equal to the spending cuts.  If the committee’s recommendations are not enacted, then the debt ceiling will increase by $1.2 trillion, and $1.2 trillion in mandatory spending reductions - evenly divided between defense and non-defense spending - will be implemented, too.  Cuts to Social Security, Me dicaid, veterans' benefits and pensions, food stamps and Supplemental Security Income are exempt from the mandatory cuts.  However, cuts to the Me dicare system are not exempt, and Me dicare payments to providers may be cut by up to 2%. 
  
  On October 4, 2011, the American Hospital Association (AHA) and HAP will conduct an advocacy day in Washington , D.C. to urge Congress to raise the Me dicare eligibility age to 67, which would reduce Federal spending by $124.8 billion over ten (10) years without adversely impacting hospital payments.  AARP argues that this proposal would merely increase the number of uninsured patients.   Other solutions proposed by AHA and HAP include increasing the use of generic drugs, raising enrollment fees, increasing copayments and deductibles for Me dicare, Me dicaid and TRICARE beneficiaries, and improving programs for end-of-life care.  We will continue to monitor these issues and provide regular updates prior to the November deadline. 

• Funding for the Affordable Care Act:  On September 29, 2011, House Republicans released a draft 2012 Labor, Health and Human Services and Education spending bill.  The spending bill attempts to derail implementation of PPACA by rescinding more than $8 billion in PPACA funding, including additional funding for the Center for Consumer Information and Insurance Oversight (CCIIO) within the Centers for Me dicare & Me dicaid Services.  The CCIIO is charged with implementing many provisions of PPACA, including overseeing the development of state insurance exchanges.  The bill would also prohibit additional funding towards PPACA programs until all constitutional challenges involving PPACA have been resolved.  Democratic members of the Labor, Health and Human Services and Education Committee oppose the bill.  The legislation is currently stalled in the House Appropriations Committee.  Congressman Dent (R-15-PA) is a member of the House Appropriations Committee.