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WHEREAS, as recently as 2018, the Council of the City of Pittsburgh ratified its recognition of healthcare as a fundamental human right through Bill No. 377 of 2018, in which the body affirmed its conviction that each and every person in the City of Pittsburgh - as well as in the United States - is deserving of robust, high-quality healthcare that provides excellent, patient-oriented outcomes; and
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WHEREAS, although the University of Pittsburgh Medical Center (UPMC) and Highmark have operated under a state-brokered consent decrees since 2014 that mandated that each party not deny in-network services to patients who held the other’s insurance, said consent decree is slated to expire on June 30, 2019; and
WHEREAS, that expiration is now colloquially referred to as a “divorce” between these two firms; and
WHEREAS, UPMC was the first integrated delivery and finance system (IDFS), an entity that holds through its common composition both healthcare insurers and healthcare providers, in the southwestern Pennsylvania region, with Highmark becoming the region’s second IDFS after its acquisition of the West Penn Allegheny Health System; and
WHEREAS, despite consent decrees, invention in the form of mediated agreements across two Governors’ Administrations, mediation actions from the Office of the Attorney General, and involvement from other state agencies was necessary simply to prevent further worsening of the situation for the region’s residents; and
WHEREAS, the Commonwealth of Pennsylvania is currently without any mechanism to reconcile conflicts between IDFS despite the outsized impact that these institutions can have on the health and wellbeing of residents because of their market share, resource consolidation, and role as both provider and insurer; and
WHEREAS, knowing that people cannot and should not be denied care on the basis of their insurance status, Pennsylvania Senator Jay Costa will soon introduce a legislative package that seeks to amend the Health Care Facilities Act to establish new requirements on hospitals operating as part of an IDSF, as well as enact the Assuring Patient Access & Consumer Choice Act, which would codify the same contracting requirements on hospital-owned physician practice organizations operating as part of an integrated delivery network; and
WHEREAS, far too many of our neighbors and colleagues can already count themselves among the innumerable people gravely and traumatically impacted by these firms’ actions, and the danger to the current and future health and wellbeing of the residents of the City of Pittsburgh and southwestern Pennsylvania is far too grievous for this dispute to be permitted to continue.
NOW, THEREFORE BE IT RESOLVED that the Council of the City of Pittsburgh makes known its support for Sen. Jay Costa’s legislative efforts to force UPMC and Highmark to put an end to their years-long dispute that has left this region’s residents caught in the middle; and
BE IT FURTHER RESOLVED that this Council hereby calls for swift, bicameral adoption of these bills upon their introduction to both Chambers of the Pennsylvania General Assembly.