Gov. Ed Rendell wants Pennsylvania businesses to offer basic health insurance to all workers and a statewide ban on smoking in workplaces, restaurants and bars under a sweeping plan unveiled Wednesday. There are nearly 600 restaurants that have banned smoking Valleywide already.
With medical costs outstripping both inflation and wage growth and the prospects for relief from Washington remote, Pennsylvania can no longer ignore its uninsured, Rendell said in the first major policy speech of his second term. Paying for them, he said, costs state taxpayers $1.4 billion annually.
Rendell stopped far short of calling for the kind of single-payer health care espoused by progressives within his party, but he described his ''Cover All Pennsylvanians'' plan as universal because it would benefit most of the 767,000 adult residents who lack medical coverage.
The sweep of Rendell's proposal made its prognosis difficult to determine. Final action on any facet seems at best months off. Four-dozen pieces of legislation, federal and state approval and a host of regulatory changes are needed to implement the program fully.
Funding for Rendell's plan would come from several sources. First, the state would impose a ''fair share'' tax — equal to 3 percent of payroll — on the roughly 100,000 businesses that do not cover their employees. In the program's first year, the first 50 employees of those businesses would be exempted from the levy, with the threshold declining each year.
Second, the state would boost its $1.35-per-pack cigarette tax by an undisclosed amount and impose a new tax on cigars and smokeless tobacco. Administration officials are withholding details until Rendell's annual budget address Feb. 6. Tobacco taxes would earn the state federal matching money.
Essentially, Rendell wants to expand the state's adultBasic insurance program, which covers people age 19 to 64 who can't afford private insurance and who don't qualify for Medical Assistance, as Medicaid is known here. He would partially subsidize insurance costs for businesses that can't afford to offer benefits to their employees.
Rendell would expand income limits under adultBasic from 200 percent of the federal poverty level to 300 percent, or from about $40,000 to $60,000 for a family of four. Those people would pay monthly premiums of $10 to $60.
Businesses with fewer than 50 employees earning less than the state's average yearly wage of $39,000 would purchase coverage at $130 a month. Their employees would pay $70 a month in premiums, but they could claim a rebate depending on their income.
Self-employed individuals earning more than 300 percent of the poverty level could purchase coverage by paying the full, unsubsidized premium of $280 a month.
Rendell called for other reforms aimed at reducing health care costs while improving the quality of care. These include expanding the Insurance Department's ability to regulate rate increases, encouraging more schools to fight childhood obesity, allowing nurse practitioners to perform more medical procedures and reducing the use of hospital emergency rooms as walk-in clinics for the uninsured.