Coalition targets health insurance costs, calls for relief

A coalition focused on healthcare affordability is reiterating calls to freeze or lower health insurance costs and will take that message to Harrisburg later this month.

The Affordable Healthcare for NEPA coalition, which recently held a virtual town hall highlighting healthcare cost and affordability challenges, plans to hold an event July 29 in front of the Pennsylvania Insurance Department in Harrisburg. The department reviews rates insurance companies offering individual and small group health insurance plans propose for the next plan year, which can't be sold to consumers without state approval.

"The goal of the rate review process is to ensure plans are priced appropriately and are not unfair or discriminatory," the department notes on its website. "During the review process, we consider the insurers' estimates of future costs, historical data, and forecasts for the upcoming year. We also factor in other information, such as the insurer's revenues, actual and projected profits, past rate changes, and the effect the change will have on Pennsylvania consumers."

The coalition, composed of the organizations Protect Our Care, Action Together NEPA, Families Over Billionaires and the SEIU Healthcare PA union, contend consumers already grappling with inflationary pressures and other affordability challenges need relief.

Statistics shared on the coalition's website show annual family premiums for employer-sponsored health coverage increased by 6% in 2025 compared to the year prior, reaching an average of $26,993 last year, the nonprofit health policy organization KFF's annual employer health benefits survey of large and smaller employers found. Workers contributed an average of $6,850 annually to the cost of family coverage, with employers covering the rest, per the survey.

Other statistics show the average cost of family employer-sponsored insurance plans having surged dramatically over recent decades. An analysis the nonprofit consumer health advocacy and policy organization Families USA released in March 2024 says the average cost of such a plan increased 223% between 2000 and 2020, citing an earlier KFF survey, while inflation-adjusted hourly wages increased by just 14.8% from 1979 to 2022.

An online survey of more than 1,400 Pennsylvanians conducted in July 2023 also found that 83% of respondents worried about affording health care in the future.

With those and other statistics in mind, coalition partners held a virtual town hall July 14 where participants shared their own struggles with high healthcare and insurance costs. Among them was Lauren Harris of Mountain Top, a registered nurse in the emergency department at Geisinger South Wilkes-Barre and the president of the SEIU Healthcare PA chapter there, who said she pays about $400 a month for employer-sponsored health insurance coverage for her and her daughter, an amount that doesn't include the added cost of copays.

"I love patient care and … the cost of healthcare is something that you put in the back of your mind when it comes to taking care of patients, and you think of their most emergent needs," Harris said at the beginning of the town hall. "But unfortunately I'm seeing more and more patients that are worried about the bill that is going to come and are asking me questions about what it's going to cost them."

"And it's unfortunate to go from your mindset of what's more important, my medical need or what I have in the bank?" she said. "That's something that weighs on us. … So working-class people, we're struggling with the rising cost of putting roofs over our heads and gas in our gas tanks. We see that the cost of living is going up. We're having a more-difficult time putting food on the table, and this is the reality of today, but on top of that we're having to pay these huge out-of-pocket costs to have health care."

A coalition press release accuses large healthcare corporations of prioritizing expansion and executive compensation and says the rise in healthcare costs is "being driven in large part by insurance and healthcare corporations' relentless focus on consolidation, which increases their market power." The 2024 Families USA analysis also says prices "have become much higher in recent years because of health care industry consolidation — particularly among hospitals and large health care corporations — eliminating healthy competition and leading to monopolistic pricing."

The coalition's release identifies the Scranton/Wilkes-Barre metro area as the "most consolidated health insurance market in the state" and notes that, in recent years, "mergers by giant health systems in NEPA such as Risant-Geisinger and Jefferson Health have dramatically increased their market power."

The need to freeze healthcare costs is made all the more urgent because enhanced Affordable Care Act insurance subsidies expired at the end of last year, and because pending Medicaid changes at the federal level are expected to result in coverage losses for hundreds of thousands of Pennsylvanians, the coalition contends.

It also called for a health insurance cost freeze earlier this year in the context of Geisinger's request that the state relax certain financial conditions imposed on several Geisinger-operated insurance providers — a request that apparently remains pending before the Pennsylvania Insurance Department.

Following its event in Harrisburg later this month, the coalition will launch a "Health Care-A-Van" Aug. 27 that will start at the Scranton State Office Building on Lackawanna Avenue and make stops in Wilkes-Barre, Hazleton and Danville throughout the day, taking the coalition's message "directly to the insurers."

"Coalition members say a healthcare cost freeze is critical for the health and economic security of the entire region," its press release notes.