Pennsylvania health insurance exchange
Pennsylvania enrollment third highest among HHS-run exchanges; Medicaid overhaul still in negotiation
By Louise Norris
December 3, 2013
In the first month of open enrollment, applications were completed for 57,674 Pennsylvania residents. 2207 of them had selected private plans by the beginning of November – the third highest total out of the 34 states where HHS is running the exchange. And nearly 3800 had been found to be eligible for Medicaid or CHIP. Thousands more people are expected to finalize their plan selections before the December 23 deadline for a January 1 effective date. HealthCare.gov is working much better than it was on October 1, but navigators in Pennsylvania were still reporting some problems with the website the first week in December.
Pennsylvania is allowing insurers to extend existing policies into 2014 following the policy cancellation compromise that President Obama offered in mid-November. Prior to the President’s announcement, a quarter of a million Pennsylvania residents – about one third of the individual market in the state – had received cancellation notices. By the end of November, two Pennsylvania carriers had agreed to extend some existing policies – including one guaranteed-issue, limited benefit plan for low-income residents – for at least the first few months of 2014.
In December 2012, Gov. Tom Corbett announced Pennsylvania would use the federal health insurance exchange rather than implementing a state-run exchange. Corbett said the U.S. Department of Health & Human Services had failed to provide adequate information, making it irresponsible for the state to proceed on its own.
Leading up to the December announcement, Corbett had repeatedly indicated his administration preferred a state-run exchange, and feedback gathered by a consultant showed broad-based public agreement. Corbett’s administration proposed establishing several, regional exchanges. However, consumer groups and legislators did not support the concept.
Rates for coverage in the Pennsylvania exchange are lower than the national average, and there are nine carriers offering 126 different individual plans throughout the state, although not all plans are available in all areas.
- Capital BlueCross
- Blue Cross of Northeastern Pennsylvania
- Geisinger Health System
- HealthAmerica PA (subsidiary of Coventry, which was acquired by Aetna in 2013)
- Highmark Health Services
- Independence Blue Cross
- Keystone Health Plan and QCC Insurance Company (subsidiaries of Independence Blue Cross)
- University of Pittsburgh Medical Center Health Plan
Although the state government has not involved itself in promoting the exchange, $7 million in federal funds went to various organizations around the state that are serving as navigators to assist people during open enrollment, which began on October 1, 2013 and runs through the end of March, 2014.
Gov. Corbett had also announced that the state would not move forward with Medicaid expansion, but reversed his course in late summer 2013, saying that the state was negotiating with the federal government to create its own version of Medicaid expansion (Healthy Pennsylvania), using the federal funds to subsidize private health insurance for low-income residents instead of enrolling them in Medicaid, and adding restrictions that would remove some people from Medicaid or charge them a “modest monthly premium.” Some media sources have reported this as Medicaid expansion, but it’s a different strategy and the details are not yet worked out. In addition, it is only expected to cover up to 520,000 of the 600,000 to 800,000 who would have been covered by an unaltered version of Medicaid expansion. Corbett’s plan has been very controversial in Pennsylvania, among lawmakers and residents alike.
In contrast with the national trend, Pennsylvania had more uninsured residents in 2012 than in 2011 – an increase of 156,000 people. Nearly 1.3 million people between the ages of 18 and 64 are uninsured in Pennsylvania. Almost 900,000 Pennsylvania residents will be eligible for tax credits to help them pay for coverage purchased through the health insurance exchange, according to Families USA.
HHS is running the exchange in Pennsylvania. You can use Healthcare.gov to get quotes, compare plans, determine subsidy eligibility and enroll in coverage.
Pennsylvania health insurance exchange links
State Exchange Profile: Pennsylvania
The Henry J. Kaiser Family Foundation overview of Pennsylvania’s progress toward creating a state health insurance exchange.
Operated by the Pennsylvania Health Department
Health Care Section, Office of the Attorney General
Serves Pennsylvania consumers with health-related problems.
(717) 705-6938 / Toll-free: 1-877-888-4877 (only in Pennsylvania)
Pennsylvania Consumer Assistance Program
Assists people with private insurance, Medicaid, or other insurance with resolving problems pertaining to their health coverage; assists uninsured residents with access to care.
(877) 881-6388 / email@example.com