Pennsylvanians to Have Many Choices on Health Exchange

When the Affordable Care Act’s (ACA) mandate requiring all Americans get coverage with a qualified health plan going into effect on January 1, 2014, Pennsylvania residents will have many health insurance companies to choose from on the Pennsylvania health exchange. Eight companies have filed individual plans and announced their intentions to sell on the Pennsylvania health insurance marketplace.

Surprisingly, one company that has a significant presence in the state, United Healthcare, has decided not to participate on the exchange, at least for the first year. Some insurance companies are taking a wait-and-see approach before entering into certain markets. They believe that the people who enroll in the plans initially will be older and sicker and will require more medical care. Insurers are concerned this will drive up premiums.

Individuals are mandated to purchase a policy through the exchange or face paying an annual penalty. Federal subsidies are available to assist low-income individuals with paying their premiums. The Pennsylvania Insurance Department approved the rates submitted by the insurers; however, federal approval is still pending. The U.S. Department of Health and Human Services, which is handling the bulk of the Obamacare implantation, must give final approval before the exchanges set to open for enrollment on October 1. Approval is expected to come in early-to-mid September.

Although Pennsylvania decided not to develop its own exchange, choosing instead to let the federal government take over the Pennsylvania health insurance marketplace, the state must still review all insurance plans to ensure the insurers are complying with state law. The federal government will be responsible for verifying eligibility and determining the amount of federal subsidies individuals receive.

Outreach Efforts in the Works

Pennsylvania received $4,196,333 from 38 federal grants to set up enrollment assistance programs in 40 health centers across the state. Those health centers operate 250 sites and will come into contact with over 671,000 people throughout the year. Of that number, nearly 27 percent are uninsured and may benefit from the Pennsylvania health exchange and the subsidies offered by the federal government. The health centers intend to use their financial awards to hire 76 new employees to help nearly 75,000 people enroll into qualified health plans.

Pennsylvania Health Exchange Health Center Grants

Pennsylvania Health Exchange Medicaid Expansion Still Up in the Air

The state has yet to decide whether or not to participate in the Medicaid expansion program offered through the ACA. Currently, there are 1,242,350 uninsured residents in Pennsylvania. Of those, 92 percent will be eligible for either federal subsidies to buy a policy through the Pennsylvania health exchange or for Medicaid. Those numbers, however, depend on the state electing to participate in the Medicaid expansion program.

If Pennsylvania decides not to participate in the Medicaid expansion, between 600,000 and 800,000 residents might not qualify for the program. Neither will they be eligible to purchase insurance through the Pennsylvania insurance exchange since they have to earn a minimum income to receive federal subsidies. There is still time for the state to participate in the program, but at this point it is unknown which way the state is leaning.

More information related to Pennsylvania’s efforts to implement ObamaCare and Pennsylvania health Exchange is available at state’s insurance department’s website. To learn more about ObamaCare in generate visit this dedicated section for articles related to ObamaCare. Since Pennsylvania’s exchange will be run by federal government, you can find more information on federal exchange here.

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