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Related Information

King v. Burwell Decision
Learn more about the hospital community’s response and the impact on Pennsylvania (Jun 2015)

Comment Letter to CMS
on eligibility redeterminations, insurance affordability programs, and health insurer issuer standards (Jul 2014)

Q & A on Designation of Certified Application Counselor
Questions and answers on becoming a certified application counselor

Talking Points: Pennsylvania’s Health Insurance Marketplace
Ten things hospitals should explain to patients, communities, and reporters

HAP/DVHC Overview
Pennsylvania rating areas and premiums

HAP Overview
Insurers on PA federal marketplace

King v. Burwell Decision Released

The U.S. Supreme Court upholds the use of subsidies for the federal health insurance marketplace. Learn more about the hospital community's response and the impact on Pennsylvania.

How Does Health Care Reform Impact Hospitals?

Provisions of the Affordable Care Act that most impact hospitals are: 

  • Expansion of health care coverage for uninsured individuals
  • Changes to Medicare and Medicaid payments to hospitals and other providers
  • Establishment of programs to improve the cost-effective delivery of quality care

Helping Pennsylvanians Find Insurance Coverage

Implementation of health care reform is well underway as the health insurance marketplace for individuals and small businesses seeking affordable health insurance is established, and states are allowed to expand eligibility for Medicaid health coverage to low-income working adults and their families.   

As Pennsylvanians shop for coverage through the state’s federally facilitated marketplace, they can get help from a number of organizations designated as navigators, in-person assistance personnel, or certified application counselors.   

HAP and DVHC of HAP are working with the Pennsylvania navigators to educate and assist hospitals and health systems in supporting individuals seeking health insurance coverage through the insurance marketplace.   

HAP continues to monitor the enrollment process for Pennsylvanians, and works with its member hospitals on educating consumers and employers about opportunities to secure affordable health insurance coverage. 

In addition, as the public, policymakers, and the media debate the meaning of Medicaid expansion in the context of the Governor’s Healthy PA initiative to reform the Medicaid program, hospitals remain focused on expanding coverage for more Pennsylvanians.

HAP Working With State Agencies on Health Care Delivery System Reform

An integral part of health care reform is the transformation of the health care delivery system to one that focuses simultaneously on three aims: better health, better care, and lower costs.

In an effort to achieve this objective, many new models of care are being developed and implemented, including accountable care organizations, bundled payment initiatives, patient-centered medical homes, and population health management.

Pennsylvania received a grant to develop a health care plan designed to foster approaches to care and payment that improve access, management of chronic disease, and coordination of care. HAP is working with the Pennsylvania Department of Health and the Department of Public Welfare on the development of the new care model.


Insurance Marketplace Resources:

PA Consumer Marketplace Website
Apply for coverage, compare plans, and enroll

CMS Information and Resources about Health Insurance Marketplace
Resources for professionals to help people apply for coverage

Kaiser Family Foundation Issue Brief 

Insights for preparing for outreach and enrollment

Certified Application Counselor Resources:

Applications for Interested Organizations
Apply online at CMS website to be a certified application counselor organization

Pennsylvania Navigators:

Resources for Human Development
Provides enrollment assistance in the ten counties in Pennsylvania with the highest rates of uninsured

Pennsylvania Association of Community Health Centers
Coordinates enrollment assistance efforts in underserved areas throughout the commonwealth using a connected and networked approach

Pennsylvania Mental Health Consumers' Association
Provides assistance to people who use or need behavioral health services, particularly those who experience serious mental illness or serious psychological distress

Mental Health America
Targets underserved individuals with behavioral health disorders who are uninsured or underinsured

Implementation Resources:

State Legislative Tracking Database
Legislation related to health care reform tracked by the National Conference of State Legislatures

Healthcare.gov Implementation Center
Highlights key features of the Affordable Care Act such as coverage, costs, and care

Related News

November 23, 2015

CMS Proposes Changes to Health Insurance Marketplace, Seeks Stakeholder Feedback

The U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) recently released its proposed Noticeof Benefit and Payment Parameters for 2017, which proposes changes to payment parameters and new standards to improve consumers’ experience for plans in the federally-facilitated Health Insurance Marketplaces. CMS is seeking comments on the proposed changes by December 21.

November 18, 2015

Behavioral Health Priorities Advance Thanks to U.S. Senators’ Leadership

Two bills addressing behavioral health priorities—prenatal opioid abuse and infant opioid dependency, and access to emergency psychiatric care—have cleared the U.S. House and await signature into law.

November 17, 2015

Rep. Tom Killion Named Leader in PA Health and Health Care

News Release:  DVHC of HAP presented its 2015 Distinguished Leadership Award to Representative Tom Killion (R-District 168) in honor of his strong advocacy for hospitals, the health care community, and health care consumers in Pennsylvania.

View all Health Care Reform News

Related Blogs

August 25, 2015

Health Care Is Changing as We Speak. Why Are We Considering Mandates Based on Yesterday’s Model of Care?

With Pennsylvania’s health care landscape evolving so quickly, are we making the best use of our time and resources by legislating hospital mandates that apply to old models of care?

April 02, 2015

Why More Health Coverage Does Not Necessarily Mean Less Uncompensated Care

Health coverage and uncompensated care are opposing forces, right? As the number of people with coverage goes up, the need for hospitals to provide charity care or cover unpaid patient bills goes down. Or will high deductible health plans disrupt the natural order of things?

November 19, 2014

Availability Does Not Ensure Access: Unlocking Pennsylvanians’ Access to Health Insurance

The Affordable Care Act (ACA) has made health insurance available to millions of Americans. But making coverage available to individuals doesn’t ensure access.

View All Health Care Reform Blogs


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