Dear Friends,
This week I want to briefly discuss a number of bills that passed the House this month and last month which include protections for health care access. A federal budget bill cutting over $800 billion to Medicaid and the Affordable Care Act recently passed the U.S House and now sits with the U.S. Senate. As written, the bill is anticipated to end Medicaid coverage for over 300,000 Pennsylvanians and further imperil more than 30 rural hospitals already struggling to stay open. In a state where almost 40% of our children, about 1.3 million, get health care coverage for general wellness, preventative care, mental health, immunizations, dental care and early intervention from Medicaid, the impact of the bill Congress passed is almost unimaginable. Approximately three million Pennsylvanians, one-third of births, and almost 60% of nursing home stays are covered through Medicaid.
The bill is expected to end insurance coverage for almost 11 million people nationwide by 2034 per the nonpartisan Congressional Budget office. In Pennsylvania, the bill is also expected to make marketplace health insurance through PENNIE unaffordable for almost half of the 500,000 people who get low-cost coverage through PENNIE as early as next year, as their plan cost will increase as much as 82%. While the Pennsylvania General Assembly can do little to undo the impact of the federal bill, we can work to enshrine health care protections into state law. We’ve already taken steps to do this by passing a package of Affordable Care Act protections earlier this year to safeguard access to health insurance, while also advancing bills to make health care more affordable and transparent, giving more Pennsylvanians the chance to get and stay healthy.
A bill I co-sponsor, House Bill 1140, which passed the House 116 to 87, protects state access to contraceptives. As we see state and federal policies limiting access to contraceptives mandated under the Affordable Care Act, the Pennsylvania House seeks to take affirmatives steps to ensure access to birth control in the commonwealth. Per Representative Leanne Krueger, the prime sponsor of the bill, ending contraceptive access would impact “the health and economic security of at least 2.5 million women in Pennsylvania who depend on the coverage funded by their employers for access to affordable, effective contraceptives.” H.B. 1140 would require all insurance policies available in Pennsylvania to cover all FDA-approved contraceptive medicines and devices, including all emergency and over-the-counter contraceptives, includes standards for ensuring patient confidentiality, and continues religious exemptions provided a contraceptive is elective rather than medically necessary. Beyond their use in family planning, contraceptives are often used to treat endometriosis, premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) symptoms and pain relief, to lower the risk of certain cancers, and Polycystic Ovary Syndrome. For many, contraceptive access is essential healthcare, and the decision to use or not use contraceptives should be made by a patient and her doctor, rather than by her government or her employer. This bill would enshrine that concept into law.
House Bill 433, introduced by Representative Gina H. Curry (which I also co-sponsored) requires health insurance coverage of diagnostic breast examinations without cost-sharing. While many women have access to free screening mammograms through their insurance, abnormalities detected that require advanced imaging such as a breast ultrasound or MRI have a high price tag. Patients face up to thousands of dollars in cost-sharing before they receive a definitive diagnosis. The financial burden often leads patients to delay or forgo life-saving tests – which can have devastating consequences. Advanced breast cancers are five times more expensive to treat and are far deadlier than those caught early. The bill passed the House 198-5 and awaits a vote in the Pennsylvania Senate.
Another bill which I co-sponsored, House Bill 688, passed 186-16. The bill adds Pennsylvania to the National Counseling Compact, an occupational licensure agreement based on the mutual recognition of both education and practices for counselors in 37 other states. Compacts work by creating mutually agreed to standards of practice. States joining compacts allow a practitioner's home state license to be recognized by other compact member states. The bill would increase the availability of mental health services in the commonwealth and provide counselors and their patients more opportunity as to where and how they provide treatment. Representative Jennifer O’Mara, the bill’s prime sponsor, shared that “more than 62% of Pennsylvania’s communities are underserved in terms of available mental health services.” The bill would allow students attending college out-of-state and Pennsylvanians working out of state to continue seeing their trusted counselors.
House Bill 79, introduced by Representative Arvind Venkat (which I also co-sponsored), establishes the Pennsylvania Medical Debt Relief Program. Medical debt continues to be a devastating burden on residents in Pennsylvania and is prevalent amongst our most vulnerable communities – detrimentally impacting their financial and overall well-being. House Bill 79 targets relief to those most in need in a fair way and avoids the concern that debt relief may incentivize over-utilization of healthcare resources or people purposefully not paying for healthcare services. The financial well-being of our rural hospitals will also be improved, as they regularly carry debt on their balance sheets with little likelihood of payment. The debt impacts their ability to deliver essential services to patients. To ensure transparency, the bill seeks to enact protections for all Pennsylvanians on existing hospital charity care programs and assistance in applying for charity care to prevent the accumulation of new medical debt.
As our state budget negotiations progress, I will continue to keep you informed of bills that will make an impact on all Pennsylvanians. If you, like me, are concerned about the impact the federal spending bill will have on our neighbors and friends as well as on delivery of health care services and hospital access nationwide, please reach out to your federal senators and share your concerns. This discussion about the impact of Medicaid funding cuts presented by University of Pennsylvania’s Leonard Davis Institute of Health Economics is an excellent resource on this topic. As PA Human Services Sec. Val Arkoosh so saliently points out in this panel, our health care system is an ecosystem. Not only does preventative and accessible care reduce later healthcare costs (both in individual cases and because of the direct cost of hospitals needing to care for uninsured patients) but it also maintains a fine balance point that ensures that our hospitals are able to remain open and available to all of us. I will continue to fight for health care access in the commonwealth, and if you think this is an essential issue, I again encourage you to reach out to your federal senators.
I also want to add that Paul Miller’s Law, Act 18 of 2024, is now in effect! The law bans drivers from using handheld devices—such as cell phones—while operating a vehicle. The law allows police officers to stop and cite drivers solely for holding or using a phone, even when the vehicle is stopped at a red light or stop sign.
The law was named in memory of Paul Miller Jr., who was tragically killed in 2010 by a distracted driver. His mother, Eileen Miller worked for more than a decade to change the law to prevent similar tragedies. While I know it will likely require we change some of our driving behaviors, as someone who lost a family member to a distracted driver, I am grateful for this change.
The law took effect on June 5, 2025. For the first year, enforcement will be limited to written warnings. Starting June 5, 2026, violators will face a $50 fine (which could exceed $100 with additional fees). Exceptions include using a phone to call 911 in emergencies and operating devices through hands-free technology, such as Bluetooth or CarPlay.