Pennsylvania Gov. Edward Rendell has unveiled a health coverage expansion proposal that builds on plans adopted in Massachusetts and announced in California.

Rendell, a Democrat, is proposing that his state phase in a requirement that adults with incomes greater than 300% of the federal poverty level buy health insurance.

Rendell also is calling for the state to work with private health insurers to set up a “Cover All Pennsylvanians” program that would provide subsidized and discounted health coverage for small business and moderate-income individuals.

Rendell is estimating the full, unsubsidized cost of the coverage would be about $280 per month.

Businesses that fail to insure employees would have to pay a “fair share assessment,” Rendell says.

Pennsylvania also would impose an “adjusted community rating” system that would prohibit insurers from using insured characteristics such as health status and gender in setting rates, Rendell says.

Rendell also has included 3 ideas not highlighted in the California and Massachusetts plans:

- A new regulation requiring hospitals to use electronic health record systems.

- A program to decrease dependence on emergency rooms by providing incentives for doctors and other health care providers who offer services in the evening and on weekends.

- Regulatory changes that would permit nurses, advanced nurse practitioners, midwives and other licensed health care providers to provide more care with less direct physician supervision.