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House of Representatives
Session of 2017 - 2018 Regular Session


Posted: April 27, 2018 02:26 PM
From: Representative Dan Frankel
To: All House members
Subject: Protecting healthcare access for all Pennsylvanians
There is no question that we must act, and act quickly, to protect access to quality health care for all Pennsylvanians by strengthening state laws.

Federal changes, both proposed and enacted, to the Patient Protection and Affordable Care Act will negatively impact the number of insured Pennsylvanians, the number of Pennsylvanians with comprehensive health coverage, and will drive up premiums for quality health coverage. A recent analysis from Covered California, California’s marketplace, identified Pennsylvania’s market as facing “catastrophic” premium increases of more than 90 percent in the individual marketplace over the next three years.

The federal changes destabilizing the marketplace include:
  • Decreasing advertising and time for enrollment
  • Eliminating the penalty for not being insured
  • Expanding access to insurance products that don’t meet the minimum standards for comprehensive coverage through Association Health Plans and Short-Term Limited Duration Plans
  • Eliminating cost-sharing reduction payments to insurers
Collectively, these changes discourage resident from purchasing health insurance before they’re sick, concentrating the less healthy population in one risk pool and driving up the cost of insurance for all. The biggest impact will be felt by middle-income consumers with health concerns. Those people making more than $48,000, for one person, or $100,000 for a family of four are not eligible for subsidies. In particular, entrepreneurs and small business owners may find their access to health insurance limited to skimpy plans with minimal coverage and no requirements to use a portion of their yield toward providing healthcare.

With this in mind, I will soon introduce a package of three bills to protect access to quality healthcare for all Pennsylvanians.

Document #1

Description: The first bill reinstates the requirement that individuals in Pennsylvania carry insurance. Younger and healthier people must not wait until they get sick to purchase insurance that covers their health needs.

Document #2

Description: The second bill calls for investment in outreach and education to support enrollment. The National Academy for State Health Policy (NASHP) released data showing that those states conducting their own outreach and enrollment saw an increase in enrollment in the marketplace over the past two years, while those dependent on the federal government for outreach and enrollment saw a decline of more than 10 percent.

Document #3

Description: Finally, the third bill protects Pennsylvania consumers from short-term limited duration plans that do not meet the basic standards for regulated health insurance, by creating the same standards for all products sold as health insurance for individuals. Currently, such plans do not meet the basic Pennsylvanian’s basic expectations for insurance. These products often do not cover pre-existing conditions, so patients may find they can’t get coverage for the services that they need. These products may not pay past certain limits, so even in catastrophic cases, insurance may run out well before health care is paid for. They do not meet basic health coverage standards for cases like pregnancy, mental health, or prescription drugs. Money paid for these products is not expected to be spent on health care services, and in fact in Pennsylvania as much as 50 percent of the premiums paid for these products goes toward profit or administration, not health care.

Pennsylvanians have come to expect health care insurance coverage to actually cover their health care needs. Legislators in Pennsylvania should fulfill that promise by requiring all products to meet the same basic standards for insurance in PA.