HEALTH CARE

Employers and employees constantly struggle with the cost and complexity of health care coverage and compliance. However, efforts to control the underlying costs of care must also take into account the effect on quality and accessibility of health care delivery in Pennsylvania. Balancing cost, quality and accessibility within the health care system remains a challenge for all stakeholders in the process, including government, insurers, providers, purchasers, and consumers.

On behalf of purchasers and consumers of health care, the Chamber believes a private health care delivery system, not a single-payer system, must be encouraged and maintained as a means to provide all Pennsylvanians with appropriate access to cost-effective, quality health care. As in any business, competition among health insurance companies and health care providers will impact the cost of health care premiums. With effective and efficient competition, employers and employees should have a greater choice of health plans, networks, and providers.

Quite often, new opportunities for a stronger, more effective health care system surface elsewhere. State government should not hinder Pennsylvania’s competitive position relative to other regions and should capitalize on emerging concepts whenever possible. In particular, Pennsylvania should support, not restrict, alternative delivery models, including advances in technology that are designed to enhance cost-effective treatment and management of health care.

In order to sustain a prosperous relationship between employers and employees and promote an attractive workforce environment, the Chamber encourages critical improvements to Pennsylvania’s business climate in order to spur private sector job creation, thereby minimizing individuals’ dependence on the Commonwealth’s medical assistance (MA) programs. Pennsylvania’s MA programs already represent one of the largest components of the Commonwealth’s General Fund budget. Any expansion of government-assisted programs at the state and federal level should be fiscally viable and sustainable without shifting costs to employers.

On behalf of employers and employees, the Chamber supports the following concepts:

• Best practices for providers that help eliminate excessive and unnecessary costs of care and ensure the delivery of high quality outcomes;
• Standard, consistent quality measures for the health care industry that are based on verifiable clinical standards;
• A cost/benefit analysis of existing mandates (any mandate in which the cost outweighs the benefit should be repealed);
• Legal reforms based on fairness, common sense and personal responsibility that will allow for a stable and predictable insurance system for providers and help to keep health care costs down;
• Standard and consistent incentives that emphasize successful health care outcomes over volume, rewarding both providers based on outcomes and overall care and consumers based on prevention and wellness;
• Innovative solutions that expand access to affordable, private coverage, such as consumer-driven health savings accounts, small-business pooling, and equal tax benefits for individual and employer-provided insurance plans;
• Empowering consumers through new technologies that give them timely, useful information about the cost and quality of their care, helping them make informed decisions that encourage competition and reduce costs;
• Reasonable prohibitions on surprise balance billing; and
• Measures, such as tax deductibility, will create more affordable health insurance options for all employers.

The Chamber opposes:

• Shifting the costs of government health care programs onto employers, providers, and insurers;
• Employer and insurance mandates, which would eliminate employers’ ability to offer flexible, cost-effective options such as ERISA plans and health savings accounts (HSAs);
• The expansion of mandated benefits, unless sufficient evidence exists demonstrating that the benefits of the mandate clearly outweigh its costs;
• Additional mandates, taxes, and fees on employers and employer-sponsored insurance plans;
• Proposals that would allow state government to place unreasonable restrictions on competitiveness and innovation in biopharmaceutical manufacturing;
• Unnecessary restrictions on prescription plan cost-savings, such as limitations on the use of pharmacy benefit managers and mail-order pharmacy services;
• Staffing mandates or other workforce limitations that limit the ability of health systems and other health care providers to effectively manage health care delivery; and
• Price controls and efforts to reduce contractual flexibility in our health care system.

Revised and approved by the Policy Committee in October 2023 and approved by the Board of Directors on November 16, 2023