Fiscal Year 2026-2027 
Pennsylvania Budget Recap
Governor Josh Shapiro and the General Assembly 
reached agreement on a $50.8 billion state 
budget nearly two weeks after the June 30 
deadline. The final spending plan represents an 
increase of approximately $1.8 billion, or 3.7%, 
over the prior fiscal year.
For PACEP the budget process was relatively 
quiet. Legislation enacted along with the state 
budget did not include significant changes 
affecting emergency medicine, scope of practice, 
or other PACEP priorities. One budgetary element 
of interest to PACEP and the broader physician 
community, however, is the transfer of money 
from the Pennsylvania Professional Liability Joint 
Underwriting Association to the General Fund.
Joint Underwriting Association 
Transfer 
The Fiscal Code legislation, a necessary bill to 
authorize budgetary expenditures, transfers 
$14.3 million from the Pennsylvania Professional 
Liability Joint Underwriting Association, 
commonly known as the JUA, to the General Fund 
for the 2026-27 fiscal year. 
The JUA serves as Pennsylvania’s insurer of 
last resort for physicians and other health care 
providers who are unable to obtain medical 
professional liability insurance through the 
traditional market. The budget does not directly 
change JUA eligibility, coverage, or premiums, 
but the transfer continues the Commonwealth’s 
recent practice of using JUA reserves to support 
the General Fund. 
The Commonwealth transferred $200 million 
from the JUA to the General Fund in August 
2025 following nearly eight years of litigation. 
The FY 2025-26 budget then required another 
$100 million transfer, which was completed in 
December 2025. The new budget authorizes an 
additional $14.3 million transfer. 
Once the latest transfer is completed, the 
Commonwealth will have withdrawn $314.3 
million from the JUA since August 2025. PACEP 
should continue monitoring these transfers and 
their potential effect on the JUA’s reserves and 
ability to fulfill its insurer-of-last-resort function.
CO Monitor Legislation  
Moving Again 
Thanks to Senator Michele Brooks (R, Crawford, 
Lawrence, Mercer), PACEP’s initiative to require 
CO monitors in childcare facilities is again moving 
through the legislative process. On June 29, 
2026, Senator Wayne Fontana (D, Allegheny) and 
PACEP Advocacy 
Update
Jonathan P. Bigley
Partner, Bigley & Blikle
Governor Josh Shapiro 
8
PACEP News

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