Wolf Vetoes Tele-Medicine Bill

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.