Congress Health Overhaul

Insurance Commissioner of Pennsylvania Theresa Miller, right, together with state insurance commissioners from left, Tennessee Department of Commerce and Insurance Commissioner Julie Mix McPeak, Washington State Insurance Commissioner Mike Kreidler; and Alaska Division of Insurance Director Lori Wing-Heier, testifies during a Senate Health, Education, Labor, and Pensions Committee hearing on the individual health insurance market for 2018 on Capitol Hill in Washington, on Sept. 6, 2017.

Despite a staggering 30 percent average increase in some premiums, more Pennsylvanians will have access to lower premiums when the federal health care marketplace opens Wednesday, advocates say. 

Analysis of premium rates, financial assistance and tax credits show 80 percent of the state’s residents will be able to find plans for less than $75 a month.

Last year, only 59 percent could get insurance for under $75 a month, the Pennsylvania Health Access Network announced.

“After reviewing this year’s plans, we are relieved to find that most people in Pennsylvania won’t feel the direct impact of the Trump administration’s decision to end cost-sharing reductions,” network Executive Director Antoinette Kraus said. “Most will be able to find affordable plans through the marketplace.”

Enrollment begins Wednesday under the Affordable Care Act, also known as Obamacare.

It continues through Dec. 15 at healthcare.gov. That’s about half the open enrollment period of recent years.

Those who don’t have health insurance or who enrolled through the marketplace last year should take time to explore their options this year, said Leslie Bachurski, director of consumer navigation and organizational development for Consumer Health Coalition.

“Even if there is an increase, the tax credit goes up with the rates to keep the cost down,” Bachurski said. “Eight out of 10 people receive some help.”

The Consumer Health Coalition and Pennsylvania Health Access Network both provide health navigators to assist residents in Cambria and Somerset counties through the enrollment process.

The federal website takes enrollees through a series of questions to help them determine the best plan. Navigators can explain various terms and help consumers understand the tax credits and other financial assistance, Bachurski said. 

Those enrolled in the Affordable Care Act silver plans face the largest increase because the federal government formerly subsidized insurance companies to cover consumers’ high deductibles and other expenses, Kraus explained. President Donald Trump earlier this month ordered the cost-sharing payments to cease. 

“Insurers still have to provide those benefits because it’s the law,” Kraus said, explaining that companies faced a choice of raising rates to replace the subsidies or get out of the ACA marketplace.

 “In Pennsylvania, insurance companies decided to raise the rates,” she said. “The (state) Insurance Department put those increases on the silver plans.”

But those who qualify can receive tax credits which reduce the monthly premium, Kraus said. Help based on income, and single taxpayers making up to about $48,000 can get some help. 

Even those with no health concerns should consider getting coverage, Bachurski said. 

“Health insurance protects your family from the unexpected,” she said. “When the unexpected happens, the last thing you want to think about is: How am I going to pay for all of this care?”

Randy Griffith is a multimedia reporter for The Tribune-Democrat. He can be reached at 532-5057. Follow him on Twitter @PhotoGriffer57.

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