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After bipartisan backing in Legislature, Pennsylvania gears as much as launch medical health insurance change – jj

After bipartisan backing in Legislature, Pennsylvania gears as much as launch medical health insurance change


Pennsylvania’s individual health insurance exchange is expected to be fully operational by 2021, a task Insurance Commissioner Jessica Altman said she knows is daunting.

“We don’t want to delay one more year of consumers seeing lower premiums because we weren’t able to get it off the ground fast enough,” Altman told those attending the Capital Blue Cross Public Affairs Program on Monday.

Gov. Tom Wolf signed Act 42 of 2019, which authorizes the new exchange, earlier this month. The legislation passed the state House and Senate unanimously.

Pennsylvania can run the health exchange cheaper than the federal government, Altman said. Those who have insurance through the Affordable Care Act pay a 3.5 percent fee, amounting to about $90 million a year in total. The state can run the program for $30 million to $35 million a year and pass the savings on to consumers, she said.

Act 42 also includes a reinsurance fund that would cover high health care costs for individuals. Pennsylvania cannot apply for a waiver to create that fund until the health care exchange is in place, Altman said.

The health exchange will be run by a new board consisting of consumers, lawmakers, providers and two other state agencies. The board will consist of legislators appointed by their caucuses. Other appointments will be made by the governor. Altman will serve as an ex-officio member of that board. A full-time executive director and other staff will be hired.

The board is expected to be in place within the next two months, and proposal requests will be sent to vendors sometime in the fall, Altman said.

State officials are taking an “interim step” this year by running the ACA’s Navigator program that helps people enroll.

Running the health insurance exchange through the state has other advantages besides costs, Altman said.

“One thing we’ve seen with the Affordable Care Act is when you cede decision making to the federal government, they are going to change their mind a lot,” Altman said. “When we bring that home to Pennsylvania, we’ll get to make those decisions, and we’ll make them in a way that we like to make decisions, which is not in a bubble, which is talking to all of the stakeholders, the insurers, the consumers and the providers in our market about what they view as important and what they see. And we get to make those calls.”

The state will also have access to enrollment data so it will know who needs to reach in open enrollment, Altman said.

The legislation has a sunset clause in case the Affordable Care Act is repealed, she said.

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