Pennsylvania health insurance exchange Archives - Safety-Net Association of Pennsylvania

PA Health Policy Update for August 29

The following is an update of selected state health policy developments in Pennsylvania from August 25 – 29. (Some of the language used below is taken directly from state documents).

Fiscal Year 2025-26 Budget Update

There was no legislative activity surrounding the state budget this week, with both houses in recess, but officials continue their informal negotiations. The budget impasse is expected to extend into mid-September.

Governor Shapiro pitched an amended budget to legislative leaders, which would increase spending by 5% rather than the 8% increase proposed in February. Democrats, including House Majority Leader Matt Bradford, showed a new willingness to help support transit operating budgets through a special trust fund – as pitched by the Senate Republicans earlier in August – if there could be a plan to replenish that fund with new revenue sources. For more perspectives and statements from other legislators on the budget, see this Spotlight PA article.

The House stands adjourned until September 22 and the Senate until September 8.

Department of Human Services

The Department of Human Services (DHS) shared several resources from the federal government on how individuals can take action to move their Social Security benefit payments to electronic payments before the September 30, 2025 deadline after which paper checks will no longer be issued to beneficiaries. This action is particularly important for administrators of personal care and assisted living facilities who may be receiving checks on behalf of their residents. DHS will host a webinar for providers on September 10 at 1pm.

DHS updated its Medicaid managed care organization directory for September 2025.

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) will kick off Recovery Month next week, with events continuing throughout September. For event details taking place throughout the state click here.

Pennsylvania Health Insurance Exchange Authority

Pennie, Pennsylvania’s official health insurance marketplace, in coordination with Health Market Connect LLC (HMC), the newly appointed contractor of Pennie’s Assister Network, are launching a new network of regional organizations dedicated to providing localized support throughout the Commonwealth.

Around the State

An op-ed from a retired county mental health commission member published in PennLive details the risk that the budget impasse poses to Pennsylvania’s behavioral health safety net.

WHYY reported on the state of traffic and commute disruptions in light of the current SEPTA service reductions and predicts how the situation will change as more cuts come into place next week.

The Pittsburgh area NPR partner, WSEA, hosted a story about how their regional transit authority’s cuts to the paratransit and ride share program will impact individuals living with disabilities.

Stakeholder Meetings

Patient Safety Authority – Sept 16

The Patient Safety Authority established by the MCARE Act will hold a virtual board meeting on September 16 at 1pm. For registration and meeting instructions, see this PA Bulletin notice.

Pennsylvania Association of Addiction Professionals (PAAP) Annual Conference – Sept 18

The PAAP annual conference will take place in Trevose, PA on September 18 from 8:00 am to 4:30 pm. The addiction-specific educational experience will feature immersive training sessions, an exhibit hall, and networking opportunities. For more information and to register, click here.

PA Safety Net Admin2025-09-02T13:49:51+00:00August 29th, 2025|Meetings and notices, Pennsylvania Medicaid, Pennsylvania proposed FY 2026 budget|Comments Off

PA Insurance Exchange Rates to Rise in 2020

Insurance premiums will rise on Pennsylvania’s new health insurance exchange in 2020, the Wolf administration has announced.

2020 will mark the first year Pennsylvania operates its own health insurance exchange under the Affordable Care Act. Previously, Pennsylvanians shopped for health insurance on the federal health insurance exchange.

Pennsylvania State Map Pennsylvania rates will rise an average of four percent for individual plans and 9.7 percent for small groups, the state Insurance Department has announced. All insurers that offered plans in 2019 will do so again in 2020 and the exchange will include a new insurer and increased choice in some of the state’s 67 counties. Beginning in 2020, residents of only six counties will have only a single insurer offering individual plans.

Learn more from this Wolf administration news release.

PA Safety Net Admin2019-10-18T06:00:04+00:00October 18th, 2019|Uncategorized|Comments Off

PA May Take Over Insurance Exchange

Pennsylvania may soon assume responsibility for providing a health insurance exchange for its residents.

When the Affordable Care Act was adopted in 2010, states were given the option of establishing their own marketplaces for health insurance offered under the reform law or having their citizens use a federal exchange established for the same purpose. Pennsylvania chose to have its residents use the federal exchange, but now, a law changing that is making its way through the state legislature.

Harrisburg, PA capital building House Bill 3, with more than 80 sponsors from both parties, would direct the state to establish its own health insurance exchange and establish a Pennsylvania Health Insurance Exchange Fund to pay for it.

After years of ceding this responsibility to the federal government, some state lawmakers now believe the state can run its own exchange more efficiently and save money by operating the exchange for less than it currently pays the federal government for use of the federal exchange. The bill’s sponsors also believe that taking over the exchange will enable the state to seek a federal reinsurance waiver that should reduce health insurance premiums five to ten percent in Pennsylvania.

House Bill 3 will be considered by the House Insurance Committee.

Learn more about what members of the House seek in the WITF radio article “Plan for Pennsylvania to take over health insurance marketplace gaining ground”; read a co-sponsor memo to state House members asking them to co-sponsor the bill; and read House Bill 3 itself.

PA Safety Net Admin2019-06-10T06:00:10+00:00June 10th, 2019|Affordable Care Act|Comments Off

PA Won’t Develop Exchange After All

Immediately after the Supreme Court verdict in the case of King v. Burwell was handed down, the Wolf administration announced that it will no longer seek to create a Pennsylvania health insurance exchange.
In a news release, Governor Wolf explained that

I took steps to protect Pennsylvania’s consumers by putting in place a contingency in the event the Supreme Court ruled people are not eligible for subsidies, but I am pleased to say that we will no longer need to rely on this plan.

See the news release here.

PA Safety Net Admin2015-06-30T06:00:14+00:00June 30th, 2015|Affordable Care Act|Comments Off

PA Seeks to Establish Health Insurance Marketplace

In anticipation of a possible Supreme Court decision that could jeopardize the health insurance of an estimated 382,000 Pennsylvanians, the Wolf administration has applied to the federal government to establish a state-based health insurance marketplace.
The Supreme Court is currently weighing a challenge to the use by some states of the federal health insurance marketplace and the contention of litigants that the Affordable Care Act specifies that insurance subsidies would only be available through state-based exchanges. If the court rules against the federal government, the insurance of residents of states that did not establish their own exchanges and who instead obtained their insurance and federal subsidies through the federal exchange will be in jeopardy.
The move by the Wolf administration is a contingency plan and does not commit the state to developing its own exchange.
For further information about the state’s application to establish a health insurance exchange, see this Wolf administration news release.

PA Safety Net Admin2015-06-05T06:00:42+00:00June 5th, 2015|Affordable Care Act, Health care reform|Comments Off

Update on PA’s Health IT Efforts

Last week leaders of Pennsylvania’s Health IT Initiative presented an update on their program’s efforts at a meeting of the Medical Assistance Advisory Committee.
The presentation focused on the distribution of funds made available through the American Reinvestment and Recovery Act of 2009. The purpose of this funding is to promote the adoption, implementation, and meaningful use of electronic health records (EHRs) by health care providers.
The presentation reviewed the goals of the program; the payments made through the state’s Medicaid program to hospitals and qualified physicians so far; upcoming deadlines for pursuing additional financial support; problems encountered by the program and lessons learned; and progress to date toward building the state’s health information exchange.
See the presentation here.

PA Safety Net Admin2015-03-03T06:00:59+00:00March 3rd, 2015|Pennsylvania Medicaid policy|Comments Off

First Peek at PA’s Health Insurance Exchange

A new report from the U.S. Department of Health and Human Services offers a first look at the health insurance choices to be available to residents of 36 states, including Pennsylvania.
According to the report, premiums before subsidies – not yet released publicly – will average about 16 percent lower than Congressional Budget Office projections.
Across the state, Pennsylvanians will average a choice of 56 insurance plans. The selection varies by region, with 42 choices for residents of the Philadelphia area and 36 for those who reside in Pittsburgh.
The health insurance exchanges are one of the main features of the Affordable Care Act.
Rate information for the individual plans will be released next Tuesday, but monthly premiums for Pennsylvanians reportedly will be lower than the average for the 36 states for which information is available.
For more on the selection of plans, see this Pittsburgh Post-Gazette article. For information about rates, including a chart that shows examples, see this report in the Central Penn Business Journal.

PA Safety Net Admin2013-09-26T06:00:02+00:00September 26th, 2013|Affordable Care Act|Comments Off

PA Gets Navigation Money

Pennsylvania has received $2.7 million in Affordable Care Act money to help individuals and families navigate the health insurance exchange that the federal government will operate for the state beginning on January 1, 2014.
The money will be divided among five groups that will help individuals figure out how to take advantage of the new health insurance exchange and obtain any insurance premium subsidies for which they may be eligible.
The five groups receiving the federal money are Resources for Human Development, the Pennsylvania Association of Community Health Centers, Mental Health America, the Pennsylvania Mental Health Consumers’ Association, and the Cardon Healthcare Network.
Learn more about the federal money, why it is being spent, and how it will be used in this PA Independent article .

PA Safety Net Admin2013-08-23T06:00:12+00:00August 23rd, 2013|Affordable Care Act|Comments Off

Corbett: Not Enough Info to Decide on Exchange

Pennsylvania cannot decide whether to operate its own health insurance exchange or allow the federal government to operate an exchange for the state until it gets more information from the federal government about the regulations governing exchanges, how much they will cost to operate, and what a partnership with the federal government might look like.
That’s the message Pennsylvania Governor Tom Corbett conveyed last week.
Health insurance exchanges are among the most important components of the Affordable Care Act. States have until December 14 to inform the federal government whether they will operate their own exchange and Pennsylvania is one of ten states that still had not made this decision.
Read more about Governor Corbett’s thoughts on health insurance exchanges and the additional information he seeks before deciding in this PA Independent article .

PA Safety Net Admin2012-12-05T06:00:55+00:00December 5th, 2012|Health care reform|Comments Off

PA Lags in Developing Health Insurance Exchange

Pennsylvania is unlikely to have a health insurance exchange (HIE) up and running when the individual insurance requirement mandated by the Affordable Care Act takes effect in 2014.
According to state insurance commissioner Michael Consedine, while Pennsylvania has laid considerable groundwork for developing its own exchange, its efforts have been hampered by lack of direction from the federal government on a number of key exchange-related issues. An August letter from Mr. Consedine to U.S. Health and Human Services Secretary Kathleen Sebelius has not yet been answered. In addition, the state legislature has not passed necessary enabling legislation.
If Pennsylvania does not establish its HIE by 2014, residents of the state will be served by an exchange established by the federal government. The state would still be free to establish its own exchange at a later date.
Read more about the situation in Pennsylvania today, what the state has done so far, and the obstacles to completing developing of the HIE in this Pittsburgh Post-Gazette report.

PA Safety Net Admin2012-10-15T10:42:06+00:00October 15th, 2012|Health care reform|Comments Off

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