We have the answer to the UPMC/Highmark dispute, but it’s up to Republicans to bring the matter to the House floor
It is now up to the state legislators to make good on what UPMC and Highmark have been unwilling to do, especially now that the Commonwealth Court announced that it would not intervene in the impending June 30 dissolution of the consent decree between both entities.
Depending on your viewpoint, that could be a good or bad thing. The upside is House Democrats currently have two pending bills that would rectify this problem. The bad thing, though, is House Democrats have been unsuccessful in getting good legislation passed through a Republican-controlled House.
I was in full support of state Attorney General Josh Shapiro’s lawsuit against UPMC, which sought to modify and indefinitely extend the UPMC/Highmark consent decrees that expire June 30. I also remained hopeful when the state’s highest court overturned the Commonwealth Court’s decision that the June 30 termination in the UPMC/Highmark agreements could not be modified, subsequently sending the case back to the latter for a new ruling.
Sadly, the Commonwealth Court again ruled against the people of Pennsylvania and decided not to intervene in the longstanding dispute.
Now it’s up to us to enact change, and we already have the tools to complete the job: House Bills 1211 and 1213. This bill package, initially introduced during the 2013-14 legislative session in direct response to the UPMC/Highmark dispute, seeks to expand fair access to hospital care by addressing hospital systems that also own or are affiliated with a health insurance company or product, known as Integrated Delivery Networks (IDN).
Hospitals operating under this business model – like UPMC – are in the unique situation of paying themselves for health care delivery, which means they can use their own system to create unfair competition; make their insurance products less expensive to consumers because other insurance companies must pay more for the same services; and can make it nearly impossible for consumers who choose their competitors’ insurance plans to receive any care at all.
This bill package would prevent this practice by requiring IDNs to fairly contract with all insurance companies.
This is the precise solution to the ongoing problem that has threatened the health care of western Pennsylvanians. It would make the UPMC/Highmark dispute obsolete, and it surely would ensure all residents, especially those in western Pennsylvania, receive the health coverage they want and need.
However, the likelihood of such commonsense legislation – bipartisan legislation at that – passing the House is unlikely due to party affiliation or lack of incentive for House Republicans, which, may I add, is the complete opposite reason we all took an oath of office.
Due to this, I want to publicly call upon Speaker of the House Mike Turzai, Majority Leader Bryan Cutler and House Republicans to make good on their promise of doing what is best for state residents by bringing these bills to the House floor and passing them in timely fashion.
The solution is there for the taking, and I find it unfair to let residents suffer despite having a sure-fire plan to rectify this matter.
We’ve done our part by providing an answer to a horrendous problem. But it’s now up to my colleagues on the other side of the aisle to put party affiliation aside and do what’s best for commonwealth residents.