Tags Posts tagged with "affordable care act"

affordable care act

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Associated Press

HARRISBURG, Pa. (AP, June 5) — Pennsylvania took a first step Wednesday toward taking over its online health insurance exchange from the federal government in a bid to cut premiums for people who buy policies in the marketplace created by the Affordable Care Act.

Legislation sponsored by the Republican and Democratic floor leaders in Pennsylvania’s House of Representatives won unanimous approval from the chamber’s Insurance Committee.

Democratic Gov. Tom Wolf is pressing for the bill to pass the Republican-controlled Legislature this month in the hope that its savings measures can be in full effect in 2021.

The administration says it can operate the exchange for less money than the federal government does and use the savings to qualify for extra federal funding for a reinsurance program that helps cover certain high-cost claims.

“The products should not change, but the prices will go down, so I think that’s why it’s a win for us here in the commonwealth,” said House Majority Leader Bryan Cutler, R-Lancaster.

In addition to its high-level support in the House, the legislation is backed by the Pennsylvania Chamber of Business and Industry, the Hospital and Healthsystem Association of Pennsylvania and the Pennsylvania Association of Community Health Centers.

Wolf’s administration says the bill would make two important changes to reduce premiums for the 400,000 people who purchase health insurance through the Healthcare.gov online marketplace.

Currently, the federal government takes 3.5% of the premium paid on plans sold through the exchange, or an estimated $94 million this year.

The state can operate the exchange for $30 million to $35 million, Wolf’s administration says.

It could then use the savings to qualify for extra federal reinsurance funds and use the money to reimburse insurers for certain high-cost claims. Those reimbursements would allow insurers to lower premiums across the board within the state’s insurance marketplace, health insurance policy analysts say.

The state’s share would be about 20% or one-quarter of the reinsurance program cost, according to Wolf administration estimates.

“Both the Trump administration and the Wolf administration are interested in it, have been supportive through the process and I was hoping we could lead by example,” Cutler said.

The Wolf administration said its analysis shows that consumers would see premiums that are 5% to 10% lower than what they would otherwise pay.

Twelve states built and operate their own exchanges, while the Washington, D.C.-based nonpartisan Kaiser Family Foundation says seven other states have started a reinsurance program. Evidence from them shows that insurance premiums paid by consumers can drop, analysts say.

States at first struggled with running their own exchanges when they began in 2014 under former President Barack Obama’s signature health care law.

But Sabrina Corlette, a research professor at the Center on Health Insurance Reforms at Georgetown University, said that operating them has become cheaper and simpler as information technology systems have improved and become standardized.

Running its own exchange also gives the state more control over it, Corlette said. As an example, she noted that the Trump administration has suggested that it might end automatic re-enrollment in the exchange’s insurance policies, thus making it more cumbersome for someone to maintain their policy from year-to-year.

But a state that operates its own exchange could simply keep automatic re-enrollment, which is standard in employer-based insurance systems, Corlette said.

Questions, please contact Jack Phillips.

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RCPA has signed on to a multi-association letter being sent to the PA congressional delegation in Washington, DC urging legislators to carefully evaluate any effort to repeal and replace the Affordable Care Act (ACA), given the critical need to maintain funding for the current Pennsylvania Medicaid program and to protect the vulnerable citizens who rely on Medicaid for critical and necessary care.

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Save the Date Tuesday, January 17:
Call Congress to Protect Medicaid Expansion

As Congress continues taking steps to repeal the Affordable Care Act, the National Council for Behavioral Health is joining together with Mental Health America, Addiction Policy Forum, Depression and Bipolar Support Alliance, and National Alliance on Mental Illness to protect the ACA’s Medicaid expansion.

Next Tuesday, January 17, we are asking advocates to join us in a nationwide call-in day to protect patients’ access to mental health and addictions services by preserving the Medicaid expansion. By taking just 10 minutes next Tuesday to call your Representative and two Senators, you will join thousands of dedicated advocates to have your voice heard in Congress. Join us and help save Medicaid expansion in 2017!

Why is Medicaid expansion important? Medicaid expansion is vital to our community—it provides health coverage to millions of Americans with mental health and addiction disorders. Without Medicaid expansion, low-income people across the country will be left as they were before the ACA, with no pathway to affordable health coverage.

Why advocate now? It is urgent that we defend Medicaid expansion now before Congress votes on ACA repeal. The more noise we make now, the better our chances of delaying or stopping future cuts to Medicaid.

Call-In Day Prep: Mark your calendar for January 17! The National Council will send out more information including step-by-step instructions for National Call-In Day to Protect Medicaid Expansion next week. In the meantime, you can prepare for your calls by reviewing these Call-In Day Instructions and Medicaid expansion talking points.

Have questions? Please feel free to reach out to Stephanie Pellitt at StephanieP@thenationalcouncil.org.

Thank you for your continued hard work and advocacy as we work to protect Medicaid in 2017.


Chuck Ingoglia
Senior Vice President, Public Policy and Practice Improvement
National Council for Behavioral Health