Health Care Reform

HAP has long supported efforts to ensure coverage for all individuals. The Affordable Care Act (ACA) framework—which offers subsidized coverage through health care insurance exchanges, combined with expanded access to Medicaid—provides the most viable pathway to expand coverage and reduce costs.

More than 1.1 million Pennsylvanians have benefited from access to coverage. Millions have benefited from consumer protections—coverage for pre-existing conditions, no lifetime limits, minimum essential benefits.

In Pennsylvania, the ACA’s individual and small group health insurance plans remain stable. For 2019, in aggregate, individual plans showed a 2.3 percent rate decrease statewide and an average 2.6 percent increase for small group market plans. All but ten Pennsylvania counties had more than one insurer offering coverage and additional insurers joined the individual market in 30 Pennsylvania counties.

Despite those successes, the Administration and some lawmakers have challenged the law and taken steps to weaken consumer protections. There is increasing conversation about proposals to establish a government-run, single-payer, universal Medicare program.


Advocacy

HAP’s advocacy strategy to ensure affordable, comprehensive coverage for as many Pennsylvanians as possible includes:

  • Partnering with partners including the Pennsylvania Insurance Department and other health care stakeholders to increase enrollment through education and outreach strategies
  • Working with the state Congressional delegation and federal policymakers to maintain comprehensive health coverage and oppose policies that weaken coverage provisions
  • Supporting the Wolf Administration’s efforts to enforce consumer protections in the ACA, and to nurture a stable insurance market

HAP supported Act 42 of 2019, which paves the way for the Pennsylvania Insurance Department to seek a federal waiver to create a state-based health insurance exchange by 2021. 

Rural Health Model

Health care reform goals include improving overall health and lowering costs with an emphasis on public health and wellness, disease management, and fewer hospital admissions. HAP supports the state’s Rural Health Model, or rural global budget pilot, which officially launched on January 1, 2019, with five participating hospitals and five participating payors.

The pilot changes the way rural hospitals are paid in order to:

  • Provide predictable hospital finances, prevent hospital closures, and avoid the loss of hospital services and jobs
  • Reward hospitals financially for improving the health of communities and reducing the need for intensive—and expensive—acute care

With predictable annual budgets, hospitals can invest in the health care services communities need most, focusing on effective ways to improve health and reduce the need for expensive emergency and inpatient care.

Rural Health Redesign Center

HAP supports Senate Bill 314, Sen. Lisa Baker (R-Luzerne), legislation aimed at improving the financial stability of rural hospitals. The bill establishes the Pennsylvania Rural Health Redesign Center, which would serve as the governing body of the new Rural Health Model, which began January 1, 2019. 

HAP Contacts

For more information, contact Jeffrey Bechtel, senior vice president, health economics and policy; Laura Stevens Kent, senior vice president, strategic integration; Jolene Calla, vice president, health care finance & insurance; or Kate Slatt, vice president, innovative payment and care delivery. For media inquiries, contact Rachel Moore, director, media relations.

HAP News

September 18, 2020

Hospital Employees Encouraged to Register and Vote in November Election

The outcome of this year’s election will be critical to those who work in health care because those who are elected will make important decisions that affect health care as well as Pennsylvania’s hospitals. HAP is supporting the American Hospital Association’s “We Care, We Vote” campaign and is encouraging hospital employees to register to vote and to vote on November 3.

September 17, 2020

CMS Releases Guidance on Advancing Value-Based Care for Medicaid Populations

This week, the Centers for Medicare & Medicaid Services (CMS) released guidance aimed at assisting states in moving to value-based care models within their Medicaid populations. In keeping with its strategy to enhance and increase value-based care models for Medicare beneficiaries, CMS believes aligning the Medicaid program, as well as encouraging private payors to adopt similar new payment models, will help drive care transformation and adoption of these new models. The guidance also includes new flexibilities awarded to states to help them with this transition.

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