The Herald, Sharon, Pa.

September 30, 2013

Pa. health insurance exchanges full of confusion

By John Finnerty
CNHI Harrisburg Correspondent

HARRISBURG — Tuesday is the first day Pennsylvania residents can sign up to enroll in health insurance available through exchanges created under the Affordable Care Act.

But Medicaid reforms sought by the Corbett Administration have not yet been approved by the federal government. That creates a unique circumstance: The working poor whose income is 139 percent of the poverty line are eligible for assistance on Oct. 1. But poor workers with income less than 138 percent of the income are left out in the cold until the state’s Medicaid expansion plan is approved.

“Not only does this not help people who need it, but it’s created a lot of confusion,” said Roy Landis, an advocacy representative for the AARP in Pennsylvania.

Landis said the AARP has fielded numerous calls from people trying to make sense of how the changes in the law will effect their lives. In some cases, the changes mean one spouse may have government-provided health care, but the other still remains uninsured because of the delay in resolving the question of Medicaid expansion, he said.

Earlier this month, Gov. Tom Corbett announced that he hopes to use federal dollars available under the Affordable Care Act to enroll 500,000 mostly working poor Pennsylvanians in health insurance through the exchanges. The governor hopes to rely on private insurers instead of expanding the state’s Medicaid program. It’s an approach being sought in several other states. Corbett is also hoping to go one step further by requiring cost-sharing and adding job-search requirements.

Corbett also refused to operate the insurance exchanges, leaving that task to the federal government.

According to estimates released this week, insurance offered through Pennsylvania’s exchanges will be among the least expensive in the country.

Factoring in tax credits, a family of four in Pennsylvania with $50,000 in annual income will pay an average of $282 a month for a benchmark policy known as the second-lowest-cost silver plan. It would cost $675 without the credits. A 27-year-old in Pennsylvania making $25,000 a year will pay on average $145 per month for the same policy, or $187 before the tax credit.

Landis said that despite the political posturing, the staff at the state’s Insurance Department appear to be working diligently to help get the exchanges up and running.

The Insurance Department has launched a special website – – to help residents understand the changes, said agency spokeswoman Rosanne Placey. That website includes information for residents and small business owners.

Placey said that it is also important for residents to understand that while enrollment in the insurance exchanges open this week, the insurance coverage does not kick in until January 2014. As a result, despite the attention given to the launch of the exchanges, residents have time to determine what they ought to do.

However, it’s unclear how much lag time is required to process an individual’s application for coverage. So it may not be wise to wait until in the middle of December and expect to have coverage at the start of the year, she said.