Pennsylvania must inform the federal government by November 16 whether it intends to create a state health insurance exchange as envisioned in the Affordable Care Act.
If the state decides not to create its own exchange, the federal government will create an exchange for it.
While some observers believe the state has intentionally not invested a great deal of time and effort in developing the exchange – or spent any of the $33 million the federal government gave it for this purpose – state officials insist that they are moving ahead with the work but have been hampered by a lack of direction from the federal government.  In August, state insurance commissioner Michael Consedine wrote to U.S. Health and Human Services secretary Kathleen Sebelius seeking such direction but has not yet received a response.
Other states are in the same situation as Philadelphia – so many states, in fact, that many observers believe the federal government will extend the deadline for states to declare their intentions.Read more about this situation and what it means for Pennsylvania in this Allentown Morning Call article.