Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Insurance Exchange Advocates Argue on but Harrisburg Sees Little Support for a State-Run Option

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Insurance Exchange Advocates Argue on but Harrisburg Sees Little Support for a State-Run Option

Article excerpt

Patient advocates aren't giving up on a state-based insurance marketplace option that Democratic Gov. Tom Wolf ditched last month.

The independent setup adopted in 16 states could offer cheaper, better-tailored health coverage for more than 470,000 Pennsylvanians who buy through the federal marketplace at Healthcare.gov, policy analysts say. Some premiums for comparable policies can run about 12 percent less in states with their own exchanges, the journal Health Affairs found.

"We could take control in regulating our market," said Antoinette Kraus, state director at the Pennsylvania Health Access Network in Philadelphia. She said a state-run shop might avoid "a one-size- fits-all approach from the federal government."

A streamlined exchange could make it easier for Pennsylvanians to browse insurers, sign up for subsidies and enroll in coverage mandated under the Affordable Care Act, said Ms. Kraus and Jason Snyder, executive director at the North Side-based Consumer Health Coalition. Their members include several dozen health-related organizations that advocate easy access to care.

Still, the governor's spokesman Jeff Sheridan said the administration has no plans to revisit the state marketplace idea, which Mr. Wolf floated this spring. Some lawmakers worry that switching from the federal marketplace could confuse insurance buyers and would not be guaranteed to save enrollees - or the state - any money.

"I think perhaps we're too far down the line to jump back and do it," said Sen. Patricia Vance, R-Cumberland, who chairs the state House Public Health and Welfare Committee. She said multimillion- dollar federal grants available to establish state-based exchanges several years ago have since petered out.

Former Republican Gov. Tom Corbett declined in 2012 to create a state marketplace, making Pennsylvania one of 34 states to rely on federal insurance marketplaces. Mr. Corbett said at the time it wasn't clear how much a state-based system might cost Pennsylvanians.

Several states that built their own markets have since hit severe problems, saddled with budget overruns and error-prone computer systems that complicated enrollment. Some are weighing whether to overhaul their arrangements, although analysts said it's too soon to know how many states will swap one model for another.

"The absolutely clear benefit is there's much less burden on the state if the federal government is running the marketplace," said Jennifer Tolbert, state health reform director at the Kaiser Family Foundation in Washington, D.C. She said technology has proven "a lot costlier than expected," with some states estimating more than $100 million in initial expenses, including for customer service call centers.

Mr. Wolf said in May he might pursue a state-run marketplace as a contingency, a legal mechanism to safeguard subsidies that help about 382,000 Pennsylvanians pay for health coverage. …

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