Critical Condition

Hurting Pennsylvania

Via Heritage:

In its analysis of Pennsylvania, Lewin presents data estimating the impact of the bill, assuming

eligibility to the exchange is open to all employers beginning in year three, on sources of

coverage and potential changes in physician and hospital incomes. The highlights of the report

on Pennsylvania include:

Effects on Private Coverage and the Uninsured

• 51 percent of privately insured Pennsylvania residents would transition out of private

insurance. Of the estimated 7.6 million Pennsylvania residents with private health

insurance, there would be a decline of 3.9 million people with private coverage.

• 59 percent of Pennsylvania residents with employer-based coverage would lose their

current insurance. Of the estimated 7 million Pennsylvania residents with employerbased

coverage, 4.1 million people would be shifted out of their current employer-based


• 80 percent of Pennsylvania residents in a health insurance exchange would end up in the

public plan. Of the estimated 5.5 million Pennsylvania residents who would obtain

coverage through an exchange, 4.4 million would be covered by the public plan.

• 32 percent of the uninsured in Pennsylvania would still lack coverage. Of the estimated

1.4 million Pennsylvania residents without health insurance, the legislation would only

reduce the uninsured by 952,600, leaving 447,400 Pennsylvania residents without


Effects on Physicians and Hospitals

• Physicians in Pennsylvania could see their net annual income decline by $321.4 million,

an average loss in income of $6,480 per physician. Of this net loss in income, $1.832

billion is attributable to the public plan using Medicare-based payments. Today,

Medicare physician payments in Pennsylvania are 76 percent of private payments.

• Hospitals in Pennsylvania could have their net annual income fall by about $2.7 billion,

with hospital total margins dropping to -1.6 percent. This loss in hospital income,

greater than total hospital margins, is overwhelmingly attributable to the public plan

using Medicare-based payments. Today, Medicare hospital payments in Pennsylvania

are 71 percent of private payments.

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