At the Tuesday, November 10 County Commissioners meeting, a NewsLanc reporter asked the Commissioners to weigh in on PA House Bill 247, which would require health care providers to apply for a certificate of need (CON) before proceeding with any expensive equipment upgrades or service expansions. This would include the construction of new facilities, like the one proposed by Lancaster General for West Earl Township.

HB247, also known as the Health Care Facilities Act, would bring CON to Pennsylvania for the first time since an earlier program expired in 1996.

Commissioner Craig Lehman, who worked in the State Legislature during that 1996 expiration, said that it will be important for this proposed legislation to effectively reign in medical expenditures without unduly limiting the availability of services: “I think the overall goal of certificate of need is to try and find a balance of infrastructure improvements in our medical systems…[so] that we are mindful of costs, without impacting access. I think that’s the balance that should be struck, if certificate of need is ever going to be reenacted.”

“I don’t know what the likelihood of certificate of need being reauthorized or not [would be],” Lehman added, “But I think that those are some of the things that are going to have to be discussed and debated and analyzed before certificate of need is reauthorized.”

Regarding the anti-CON assertion that regulated competition could lead to higher costs, Lehman said, “I think many of those issues remained unresolved, which is why it wasn’t reauthorized back in the mid-90s.”

Having not read the actual bill in its entirety, Commissioners Scott Martin and Dennis Stuckey declined to comment on HB247 for the time being.

Also at the meeting, the Commissioners voted 2-1 for the County Government to join the Pennsylvania County Health Insurance Purchasing Cooperative. Lancaster County will cover its employees through this pool of self-insured counties, having now terminated its full-insurance plan with Capital Blue Cross. The new plan will not alter any actual benefits for County employees.

Commissioner Martin, who voted in favor of the change, said that the bargaining power of this co-op will allow the County to shave about $1 million off the $21 million presently budgeted for employee health coverage. Also, Martin said, the new plan will enable the County to save money when employee health is strong: “When we have good years, we can sweep those savings back off the table and not just turn them over to an insurance company.”

Commissioner Lehman, who gave the only dissenting vote, maintained that the County’s full-insurance contract with Capital Blue Cross “protects the County better” with regard to financial risk: “In this economy,” Lehman said, “managing risk is important.” Lehman was also hesitant to support the measure due to the fact that Lancaster County would be the largest entity to join the co-op thus far. “What I think is going to end up happening is that…, if Lancaster County opts into [this] small county consortium, then we’ll be a marketing tool to create a large county consortium with other large counties in Pennsylvania,” Lehman asserted, “And I don’t like government being in the position to market any private product under any circumstances.”