Pennsylvania Health Insurance Exchange

Pennsylvania Delayed Implementation of Health Exchange and the Federal Government Likely to Step In

Pennsylvania does not have a necessarily high percentage of uninsured residents. However, due to their population numbers, 11% of the population still totals around 1.4 million uninsured state residents. This problem is not confined to Pennsylvania. To the contrary, Pennsylvania has one of the highest percentages of insured residents nationwide. The entire United States has been suffering a health care crisis due to the fact that many individuals, families and small businesses have been denied access to affordable health care.

In response to the nation’s health care crisis, President of the United States Barack Obama has signed the Patient Protection and Affordable Care Act (ACA) into law on March 23, 2010. This piece of legislation is the most impacting health care law since 1965 when Social Security was created. One of the key provisions of the ACA is that every state must have a Health Insurance Benefits Exchange in operation for their state’s residents by January of 2014. If the state is choosing to create, implement and operate their own independent exchange or partner with nearby states to operate a regional exchange, they were given until November of 2012 to submit a declaration letter and their exchange’s blueprint to the United States Department of Health and Human Services. If this deadline is not met, the federal government, in partnership with a non-profit organization, will be the one to establish the Health Insurance Benefits Exchange on behalf of the state’s residents.

A Health Insurance Benefits Exchange, often referred to simply as an exchange, is a marketplace where consumers would be able to shop and compare available health insurance policies to see which one is best suited to meet their needs. Since many of these consumers will be first-time shoppers in regards to health insurance, these exchanges are required to provide an easy-to-use comparison tool that allows consumers to see the differences in cost, coverage, benefits, quality, member satisfaction levels and more between the plans. Initially these exchanges will be open to individuals, families and small business (which are normally defined as those with one hundred or fewer employees).

Governor Tom Corbett does support a state-run exchange. However, Pennsylvania was one of several states to challenge the constitutionality of the Patient Protection and Affordable Care Act, which was eventually upheld by the United States Supreme Court. Due to the delay in challenging the law, Pennsylvania has not made sufficient progress on their planning for the state-run exchange, and will likely have to have the federal government step in, at least at first. States for which the federal government has had to step in still have the option to proceed with the creation of their own exchange and can, with twelve months’ notice to the U.S. Department of Health and Human Services, begin to operate their own exchange in the future.  Proposed legislation has been drafted to create private consumer exchanges, but these drafts have failed to garner support due to their perceived inconsistencies with the requirements spelled out in the Patient Protection and Affordable Care Act.

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