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PA Insurance Department Contemplates State-Based Health Exchange

May 16, 2019
9:50 AM

IA&B met this week with Pennsylvania Insurance Department (PID) representatives to learn about their proposal to transition Pennsylvania to a state-based exchange and pursue a federal waiver (a 1332 State Relief and Empowerment Waiver) to implement a reinsurance program – all with the goal of lowering premiums in the state’s individual health insurance market.

Currently, there are over 400,000 people receiving their coverage through the individual market. The PID believes that the combination of transitioning to a state-based exchange (operating for less than the federal exchange) and obtaining a waiver for a reinsurance program will lower health insurance premiums in that market 5-10% without the need for any additional funds from the state.

During our meeting, IA&B talked with the PID about the current issues with the individual market, including the inability of many independent agents to continue helping clients obtain coverage due to carriers reducing or outright eliminating commissions, as well as affordability issues in the marketplace for consumers. We offered ourselves as resources for the future as the PID continues to fine-tune the specifics of their proposal.

In order to establish the state-based exchange, the General Assembly must pass legislation. The PID is urging lawmakers to pass a bill within the next month so that the exchange can be operational by 2021.