Pennsylvania is building on its existing Office of Health Care Reform, established by Governor Edward G. Rendell in 2003, to implement national reform. In May 2010, the governor issued an executive order to expand the Office to include a new Health Care Reform Implementation Committee of cabinet-level officials from health and human services agencies and a new Health Care Reform Advisory Committee, comprised of the same officials as well as stakeholder representatives and experts. These two groups will collaborate to organize and lead the state's implementation efforts.
"Having a longstanding office with a staff dedicated to health reform is an advantage for Pennsylvania, especially in challenging budget times," said Ann Torregrossa, director of the health care reform office. The Office already has achieved significant statewide health reforms, including the Cover All Kids program, which expanded coverage for children up to 300 percent FPL, and ongoing development of the state's Health Information Exchange.
The Health Care Reform Implementation Committee's role is to develop plans for the state's high-risk pool, insurance market exchanges, and needed technical assistance. The Implementation Committee meets every two weeks and over time will develop a strategic plan, identify state legislative action that will be required, draft legislation, and create inter-agency teams as needed to implement reform.
The Implementation Committee will collaborate with the Advisory Committee, which includes all the members of the implementation committee, eight legislators, and representatives of hospitals, medical professionals, group health insurance purchasers, budget and health policy experts, advocates, and at least one uninsured consumer. The Advisory Committee will meet monthly to review and comment on the strategic plan developed by the Implementation Committee, identify best practice models, and provide input to the Implementation Committee on the issues it is examining.
While Pennsylvania is working on a large number of health reform implementation tasks, Torregrossa identified a few immediate priorities:
- High-risk pool: Pennsylvania is one of 30 states that has chosen to administer a high-risk pool. The Centers for Medicare and Medicaid Services approved the state's proposal for its pool in late June and the state began enrollment in July, with coverage starting in August.
- Exchange planning: Pennsylvania will pursue the health insurance exchange planning grants authorized in health reform, which will be available by March 2011 to support state activities related to establishing exchanges. The state has begun planning for the design and implementation of an exchange, and the Advisory Committee met in late June with officials from the Massachusetts Health Connector to learn from that state's experience.
- Transition planning: There may be a large number of new state staff working on health reform implementation after the November gubernatorial election, so gathering data and making recommendations that will inform and support the next administration's work is a priority. The Advisory Committee is synthesizing information on topics including characteristics of the uninsured and what the state will need to do to set up an exchange as background to make recommendations on the many elements of reform likely to be implemented by the next administration.
"You can't start planning for this early enough," said Torregrossa. "For example, developing an exchange that is consumer-friendly, with a universal application for all users, requires years of work on information systems and data sharing. States will need legislation next year to implement this and other elements of health reform."
As in many states, there has been political opposition to health reform in Pennsylvania—it is one of the states where the Attorney General is challenging the law—so navigating political challenges will be an important component of implementation. Torregrossa highlighted the value of fostering a collaborative political climate. With this goal in mind, the Advisory Committee is making the implementation process as transparent and inclusive as possible. The Committee includes members of both the Republican and Democratic parties and, in addition to its publicly announced meetings, will be meeting with lawmakers on an ongoing basis.
For more information, see: Governor's Office of Health Care Reform.