Affordable Care Act open enrollment ends Friday in Pennsylvania

Jan. 15—Friday is the last day of open enrollment on Pennsylvania's new health insurance exchange, called Pennie, and the state is close to last year's enrollment of individuals through the marketplace established under the Affordable Care Act.

As of Wednesday, 328,024 Pennsylvanians had enrolled, compared with 331,825 at the end of last year's open enrollment period. Consumers have until midnight Friday to buy a plan at pennie.com. Help is also available by telephone, toll free, at 844-844-8040 until midnight Friday night.

"I didn't expect us to match last year's number," said Zachary Sherman, Pennie's executive director. "As a result of COVID-19, we haven't been seeing people leaving Medicaid enrollment. The Department of Human Services has not been terminating people off of Medicaid unless they voluntarily leave."

Consumers who turned to Pennie for insurance were expected to find that average premiums were 3.3% lower than last year, though experts warn that premium rates don't always translate into lower overall costs because of the way subsidies work and because premiums don't include costs such as deductibles and copays.

In Southeastern Pennsylvania, the lowest-cost Silver plan's premium for a 40-year-old man not eligible for a tax credit was $446 a month, down 3% from $461 last year, according to the Kaiser Family Foundation. The plan was offered by Centene, a relatively new competitor to Independence Blue Cross, the region's dominant health insurer.

In New Jersey, open enrollment continues until the end of January at GetCoveredNJ. A recent enrollment snapshot was not available for New Jersey.

Marketplace enrollment in Pennsylvania has fallen every year since 2015, when it peaked at 472,697, before the state expanded Medicaid, according to data on the Kaiser Family Foundation website. Enrollment peaked in 2017 in New Jersey.

Experts have attributed steady declines in marketplace enrollment to the shortening of enrollment periods, the elimination of the individual mandate, rising costs, the availability of more options for insurance that don't meet ACA standards, and Medicaid expansion.

Both Pennsylvania and New Jersey started operating their own exchanges with the help of a California technology company called GetInsured for the current enrollment period, as opposed to piggybacking on the federal enrollment site, HealthCare.gov.

"We saw a smooth transition," said Antoinette Kraus, executive director of the Pennsylvania Health Access Network, a Philadelphia nonprofit consumer group

"The fact that Pennsylvania did a reinsurance program helped drive down rates for some groups. The fact that we could extend open enrollment period past what HealthCare.gov could do are all important steps in making sure people have access to coverage," Kraus said.

Sherman said that without the new reinsurance program, which is effectively insurance on insurance for large claims and is being paid for with money that used to go the federal government to pay for HealthCare.gov, average rates would have been 5% higher than they are.

"It's invisible to the consumer," Sherman said, but "it has the effect of reducing the overall level of risk."

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