Landmark Telemedicine Measure Pulled Offline By Wolf Veto

 

Agree or disagree with his priorities and methods, Governor Ed Rendell was unmatched in his
enthusiasm and capacity for doing big deals to achieve as much of his agenda as he could. He would lay
out ambitious spending and program plans, and then say to critics and opponents, just tell me what you
want and we can do a package. Other times he would accept cutting legislators in on slicing the pie to
get their assent. Each side could gain something desirable otherwise unobtainable. Rendell’s approach
only came up short when the folks across the negotiating table did not have anything they wanted to
trade for. Process purists were appalled by such horse trading, but others found this brokering
preferable to political gridlock.

In approach, Governor Tom Wolf is the polar opposite of Rendell. Oh, he conjures plenty of
deals. Trouble is, he seemingly negotiates with himself. He picks something for which there is
substantial legislative opposition, say a severance tax, and baits it with a popular program, such as a
grab bag of infrastructure improvements. Year after year he does this, despite compiling a batting
average of success far below the Mendoza line. Before pandemic lockdown torpedoed state revenues,
Wolf pitched grabbing horse racing money and harnessing it to student scholarships. Now it is legalizing
recreational marijuana and firing up the proceeds for pandemic recovery measures.

Executive actions taken by Governor Wolf to counter the spread of coronavirus have sparked
citizen protests and provoked a running firefight with state legislators. It will take a while to arrive at
judgments of right and wrong in the state and federal courts and in the court of public opinion. While
making for interesting case studies in government classes, these disputes are hardly fate of the
commonwealth material.
Less noticed was the exercise of an indisputable gubernatorial power that may well represent
Wolf’s most antagonistic action toward the greater public interest.

Even before the coronavirus severely afflicted health care delivery, providers, patients, and
public officials were confronting serious challenges of access and affordability. There was rising
recognition that Pennsylvania needed to legally untangle complications preventing wider deployment of
telemedicine, a promising technological remedy. Legislative work commenced in earnest several years
ago. Issues such as licensure and liability were worked through, yielding a product that drew
overwhelming bipartisan support in the state Senate.

However, a substantial roadblock was thrown up in the state House, where pro-life legislators
sought to slam the door to abortion medications. For months extending across two legislative sessions,
this stalled the push. Eventually, enough legislators decided telemedicine was critical to health care,
and doubly so in the perilous environment of a pandemic, that the provisions were added and the bill
sent to the governor.

Who promptly and proudly vetoed it. Predictable? Yup. Worthy of acclaim? Not so much.

Folks on every side of the health care equation have to be wondering what sort of scale Wolf
used to weigh competing interests. Telemedicine is widely acclaimed as a game-changer for the delivery
of health care. The restrictions imposed in trying to contain the spread of coronavirus have amplified
the need. Every analysis of the coronavirus impact notes the expansion and efficacy of telemedicine as
a singular constructive consequence.

Look at the checklist of advantages arising from the vetoed legislation. Broadening the
spectrum of professions eligible for insurance coverage of their services. Allowing for the use of
technology for even more than the important connection with hard to reach or reluctant to engage
patients. Developing capacities for monitoring treatments, increasingly crucial given the limitations on
travel and access arising from the pandemic. Ensuring fair payment for practitioners while helping
protect patients from surprise billings.

As for the abortion stakes, this was not a huge win or loss in practical terms. Of course,
psychological one-upmanship is a different scorecard. Wolf in this situation is like a hot goalie carrying a
so-so team, because the General Assembly has yet to override a veto during his six years.

Cloaking himself in political piety, the governor suggests legislators send him a clean bill.

Everyone knows telemedicine lost two years because its merits and the concerted advocacy of health
care providers were not enough to carry it past pro-life concerns. Why in the world would anyone
reasonably believe pro-life advocates would suddenly surrender a win born of tenacity and fervor?

Without question, Wolf has every right to hold and espouse his beliefs. Elected twice as
governor, he has been granted strong power to act on those beliefs. At the same time, Pennsylvanians
have every right to examine the telemedicine veto and conclude that he has allowed his personal beliefs
to override a compelling public interest. For someone who persistently touts his experience as a
businessman, Wolf sure seems to rely on liberal philosophy as his chief gubernatorial operating
principle. People outside of politics get frustrated by the gamesmanship that intrudes on every issue of
consequence. A swath of the population in the political middle believes the politics of abortion should
not subsume other issues. However, the two sides have been going at it hammer-and-tongs for nearly
fifty years now, so we are well past wishing and hoping things will magically become less relentless.
In the extreme tug-and-pull of the legislative process, the pro-life position prevailed in this
round. Accept it, and renew the fight next time. To the detriment of health care provision and those in
need of better access to preventive and primary care, Governor Wolf was apparently unwilling to take a
higher view of responsible leadership for a commonwealth in crisis.

Nothing contained here should be considered as an attempt to aid or hinder the passage of any legislation before the General Assembly.

The views expressed here are those of the author and not necessarily those of the Susquehanna Valley Center.