Bills would require hospitals accept any willing insurer

Two Pennsylvania House members want to require hospitals and hospital-owned doctor practices must contract with any willing insurer in newly introduced legislation--a direct result of the ongoing battle between Highmark and UPMC.

Pennsylvania Reps. Dan Frankel (D) and Jim Christiana (R) say their bills (H.B. 1621 and H.B. 1622) will make the state's healthcare market more competitive by limiting power providers gain through consolidation and prohibiting hospitals from demanding unreasonable rates from insurers.

"Hospitals across Pennsylvania--and the country--have begun to consolidate into large systems. These systems can bring great benefits, such as better coordinated care, but without checks and balances in place, we can end up with systems that cost much more, without much better service. This legislation will help solve that problem, by ensuring that no matter how big a system is, it still must compete," Frankel said Wednesday in a statement.

"I am the first to criticize government for putting its nose where it doesn't belong," Christiana said Wednesday at a press conference announcing the bill, reported the Pittsburgh Post-Gazette. "However, I am convinced that the consolidation of hospitals and doctors' offices and the power of large healthcare providers demands that the government put safety nets in place to protect the interests of all Pennsylvanians."

But some groups don't support the legislation, believing it's an attempt to help Highmark grow and dominate the market. "Highmark is again looking for the government to help it perpetuate its monopoly," said the Insurance Federation of Pennsylvania, which represents UPMC. "That's what this bill is all about--not protecting consumers or giving them good choices and competition for health insurance."

Likewise, the Hospital & Healthsystem Association of Pennsylvania said the bills "go well beyond any compelling interest by state government" and "would force a specific hospital and specific health plan to contract with each other."

Highmark, however, backs the bills because they will protect the community's access to healthcare. Government action "is essential to protect the community, preserve provider choice, maintain continuity of care and manage growth of healthcare costs," Highmark spokesman Aaron Billger said, the Pittsburgh Tribune-Review reported.

To learn more:
- here's the Frankel statement
- read the Pittsburgh Post-Gazette article
- see the Pittsburgh Tribune-Review article