Bumpy Start for the Healthcare Marketplace

The highly anticipated “marketplace” went live online this morning and if you tried to immediately shop for healthcare coverage, odds are you didn’t get very far. The website experienced frequent crashes after going online at about 8:00am and those who were able to load the home page were sent to a virtual waiting room.

Healthcare advocates had predicted the possibility of difficulties on day one as potentially millions of Americans tried to access the website to solve their health insurance woes. They urge patience and remind you that the enrollment period continues for 6 months, through March 31st, for 2014 coverage. After that, the enrollment period for each year will run from October 1st through December 7th of the previous year.

Those seeking coverage under the Affordable Care Act should also be careful to use the proper website, which is Another website,, was also offering side-by-side policy comparisons as of Tuesday morning, but officials say in order to receive tax credits for your insurance purchase you must go through the .gov website.

If you are seeking coverage under the Affordable Care Act, advocates say you should be very careful to compare the plans that will be available to you.


health care, prescription

Report: Fewer Pennsylvanians Getting Health Insurance via Employer

The Robert Wood Johnson Foundation has been tracking a decade-long decline in the number of Pennsylvania residents who receive health insurance through their jobs.  Back in 2001 78% of Pennsylvania residents received health insurance via their employers.  In 2011; 67%. 

A new report indicates the reduction is due to a combination of fewer employers offering insurance and fewer employees selecting insurance.  “And we think that part of this has to do with the costs,” RWJF senior vice president John Lumpkin tells Radio PA.  “Over the last ten years we’ve seen that the cost of buying insurance in Pennsylvania has more than doubled, and this makes it difficult for companies to try to purchase insurance for their employees.” 

Pennsylvania’s average employer-sponsored insurance premium for individuals now stands at $5,100.  Family premiums increased from $6,400 – $14,300 over the time period covered in the study.

In all, 47-states saw a statistically significant decline in employer-sponsored insurance over the past decade.  Pennsylvania was one of 22-states to see a drop-off of ten percentage points or more, but Lumpkin says it still ranks in the middle of the pack.

Starting in 2014, Lumpkin believes the health insurance exchange, offered via the Affordable Care Act, will provide alternatives for the 33% of Pennsylvanians who do not receive health insurance through their employers. 

But will states like Pennsylvania experience a further decline in employer-sponsored insurance once the federal health care overhaul is fully implemented?  According to Lumpkin, no.  “Seven years ago Massachusetts passed a law that was very similar to what we see with the ACA, and in their experience employer-sponsored insurance – insurance through the job – has stayed exactly flat.” 

Pennsylvania has elected to allow the federal government to operate its health insurance exchange, or marketplace, but could still opt to assume control at a later date.


Insurance Rate Shock Coming for Young, Healthy People

2014 could prove to be a tumultuous year for health insurance rates.  Pennsylvania Insurance Commissioner Michael Consedine said as much when answering questions from members of the state House Appropriations Committee this week. 

Insurance Commissioner Michael Consedine

Insurance Commissioner Michael Consedine

Consedine says some segments of the population are likely to experience what he calls “rate shock,” upon full implementation of the Affordable Care Act next year.  “Ironically it’s most likely going to be young, healthy individuals who right now are getting the benefit of being young and healthy, and therefore that’s allowed in the underwriting process, and their premiums reflect that,” Consedine says.  “That rating formula goes away with the Affordable Care Act.” 

“You have it currently low for young people, and high for older and less healthy people,” Deputy Executive Insurance Commissioner Randy Rohrbaugh said, using a metaphorical seesaw analogy, “That seesaw changes.  Actually there will be winners and losers, and I think there’s going to be sticker shock on the side of the young, healthy people.” 

Sticker shock to the tune of 60% or more, Rohrbaugh estimates.

The theory, he says, is that any disruptions in health insurance rates will be short-lived.  However, he cautions that it could be a longer stabilization process should those young people opt-out of the health insurance system, and choose to take the penalty instead, under the Affordable Care Act. 

“It may take two or three years before that all will level through.”

Report: Insurance Costs Outpace Income Growth

The story is the same in all 50-states; the rising cost of employer-sponsored health insurance has dwarfed income growth over the past eight years.  A new study from the Commonwealth Fund crunches the numbers from 2003 – 2011. 

In Pennsylvania, the report pegs the combined cost for a family plan at $15,000, which is right at the national average.  “It’s an increase of 65% in just eight years,” explains Senior Vice President Cathy Schoen, who says Pennsylvanians’ median income increased only 13% over that same period.   

If trends continue at this rate the report indicates that Pennsylvania is on its way to a nearly $25,000 a year family premium by the year 2020. 

Schoen, however, believes the Affordable Care Act will slow the growth of health insurance and health care costs.  “Taking even 1% off the trend makes a real difference,” Schoen says, “By 2020 it would mean – in Pennsylvania — $2,000 more on the table for families in terms of wages or employers investing in jobs.”        

The Commonwealth Fund report is being released as governors across the nation are deciding whether to create state-based health insurance exchanges for individuals and small businesses to purchase insurance.  Pennsylvania, like 27 other states, will rely on the federal government to run its marketplace.

Corbett Passes on State-Run Health Insurance Exchange

With too many unanswered questions about the cost and regulation, Governor Corbett has decided not to pursue a state-based health insurance exchange.  Insurance Commissioner Michael Consedine calls it the best decision under the circumstances.  “What we’ve been finding out, as we’ve been going through this process and learning more information, is that the level of control and autonomy and flexibility that we thought we would have in a state exchange may not be there,” Consedine explains. 

The grassroots group Americans for Prosperity has been working the phones to lobby the administration and legislature on this issue all year, and state director Jennifer Stefano calls it the right move for the taxpayers.  “You have no control… but by the way – hey taxpayers – along with the 21 other taxes in Obamacare, you’re now going to pay for it,” she says in explaining the grassroots group’s stance on the exchange. 

While the governor’s decision comes as a disappointment to the Pennsylvania Health Access Network, director Antoinette Kraus is focused on the positive.  “Even though Governor Corbett has decided not to move forward with the state-based exchange, folks will still be able to access health insurance on January 1st, 2014, and that’s a good thing for working families and small businesses here in Pennsylvania,” she tells Radio PA. 

Kraus was referring to the fact that the federal government will now assume the responsibility of running Pennsylvania’s health insurance marketplace, under the Affordable Care Act.  PA is one of 28 states to allow the feds to run its exchange.  These states will still be allowed to opt-in at a later date.

Study Examines Rural Health Care Challenges

A UnitedHealth Group / Harris Interactive survey, of 1,000 doctors and 2,000 consumers, finds that rural Americans tend to be older, poorer and sicker than their urban counterparts.  “They tend to be more reliant on programs such as Medicare and Medicaid and they have more chronic conditions such as diabetes and heart disease,” says Dr. Lew Sandy, senior vice president for clinical advancement at UnitedHealth Group. 

In addition to its health issues, rural America already has a problem with access to care.  “The resources available to care for rural Americans are really under significant strain now, and they’re going to be under more strain as [federal] health reform unfolds,” Dr. Sandy says.  The study finds that by 2019, there could be an increase of nearly 8-million rural Americans enrolled in Medicaid and state health insurance exchanges.  “Among the 300,000 primary care physicians in the US, only about 11% practice in the rural areas.”

Where will these patients turn for care?  With no clear answer, Dr. Sandy says now is the time to get started on modernizing the rural health care system.  That starts, he says, with recruiting and retaining rural physicians.  Dr. Sandy also believes that advancements in telemedicine are ripe for revolutionizing rural health care.  “With the advances in information technology that permit care being delivered over the Internet… we think these kinds of technologies can wipe out the barriers of time, space and distance that rural Americans face.”