Pennsylvania Gov. Ed Rendell announced a proposal that would expand access to health care services, improve quality and reduce the state's health costs. The "Prescription for Pennsylvania" proposal would phase in a requirement that state residents whose annual incomes exceed 300% of the federal poverty level obtain health insurance. Residents with lower incomes would not be required to obtain coverage but would have the option of buying it at reduced rates.

The proposal also would expand Cover All Kids -- a program that aims to provide affordable health coverage for children -- to create a new initiative called Cover All Pennsylvanians that would help uninsured adults and small businesses obtain basic coverage through private insurers. Premiums for the plans would be determined by a sliding scale based on income. Rendell's proposal would create financial penalties for businesses that do not offer health insurance coverage to employees. In addition, four-year colleges and universities would be required to guarantee that students are insured or have access to a health clinic. Rendell also plans to meet with other large purchasers of health care to develop a pay-for-performance program that would link payments for health care services to the quality of care.