Insurance Commissioner Releases Recommendations to Stabilize Individual Health Insurance Market, Meets With Consumers Amid Concerns Over Potential Federal Health Reforms

CARLISLE, Pa., June 29 -- The Pennsylvania Insurance Department issued the following news release:

Insurance Commissioner Teresa Miller today released her recommendations to the head of the federal Centers for Medicare and Medicaid Services, who had requested ideas from state regulators and others on ways to stabilize the individual health insurance market under the Affordable Care Act (ACA).

In her letter, Commissioner Miller reiterated Pennsylvania's individual health insurance market is on a path to stability. She noted all five insurers in the market this year filed to stay in the market for 2018, all Pennsylvania counties have on-exchange plans available for their residents based on those filings, which means consumers would have access to subsidies to help cover the costs, and insurance companies requested increases averaging 8.8 percent for individual health plans, essentially in line with health care cost trends.

"However, this could change, depending on actions taken by the federal government. Our insurers provided information with their rate filings that show they would change dramatically if the ACA were to be repealed or rolled back, resulting in significantly higher costs to Pennsylvania consumers," Commissioner Miller said.

The insurers indicate they would request a 20.3 percent increase statewide if cost-sharing reductions, payments to help lower income individuals with deductibles, co-pays, and co-insurance are not paid, and a 23.3 percent increase if the individual mandate requiring everyone to have health insurance is not enforce, likely resulting in more younger, healthier individuals not buying insurance, leaving sicker patients as a greater part of the risk pool and increasing costs. If changes are made to both parts of the law, Pennsylvania insurers estimate that they would need to request a 36.3 percent increase statewide to compensate for the added risk.

"These are things the federal Department of Health and Human Services has control over. By allowing the law to work as it should by paying cost-sharing reductions and enforcing the individual mandate, HHS can bring stability to the individual market," Commissioner Miller wrote.

Commissioner Miller released her letter at a meeting with consumers at the Partnership for Better Health office in Carlisle, Cumberland County. She invited consumers to discuss their experiences with the Affordable Care Act and their concerns surrounding potential reforms being considered by Congress and the Trump Administration. The consumers who joined the discussion receive health insurance coverage through Healthcare.gov.

"You all are among the 426,000 Pennsylvanians who have health insurance through the individual market at Healthcare.gov, and it is your perspective that I believe needs to be amplified as potential changes to the health care landscape are debated at the federal level," said Commissioner Miller. "We must listen to the people we represent - the people who will be most impacted - as this process progresses, and I promise to keep your experiences in mind no matter what comes next."

Commissioner Miller shared her concerns surrounding predictions for the Better Care Reconciliation Act, the health insurance bill proposed in the U.S. Senate, which the non-partisan Congressional Budget Office estimates would result in 22 million people losing coverage. Because subsidies would be lower and cost sharing reductions for people making less than 250 percent of the federal poverty level would be ended in two years, out-of-pocket costs for many lower income consumers would rise sharply under this bill as well. Commissioner Miller promised that the Wolf Administration will keep Pennsylvania's consumers at the forefront and will make their concerns clear to Congress and the Trump Administration.

"Although the much of the legislative process surrounding both of these proposals has been rushed and without public input, I want to make it clear that I will do everything I can to advocate for the Affordable Care Act for the hundreds of thousands of Pennsylvanians on exchange and Medicaid expansion plans as well as the millions who have benefitted from the law's many consumer protections," said Commissioner Miller. "If federal legislation passes with the option for states to end protections for pre-existing conditions or make changes to the ACA's essential health benefits, the Wolf Administration will not seek to end these consumer protections, and we will advocate for Pennsylvanians to the federal government however we can."

With 426,000 Pennsylvanians purchasing health insurance through Healthcare.gov and 715,000 receiving health care through the Medicaid expansion, the Affordable Care Act allows more than 1.1 million Pennsylvanians to receive access to quality, affordable health insurance coverage. These Pennsylvanians could see premium increases of up to 36 percent or potential loss of coverage if Congress and the Trump Administration take adverse action against the Affordable Care Act. Beyond this, millions of Pennsylvanians, including those who receive coverage through their employer, benefit every day from the law's essential health benefits and the ban on annual and lifetime limits.

For more information on the Affordable Care Act in Pennsylvania, visit www.insurance.pa.gov.