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PA Insurance Commissioner Calls on Congress to Strengthen Health Insurance Protections to Help Pennsylvanians

Pennsylvania Insurance Commissioner Jessica Altman issued a letter to Pennsylvania’s Congressional delegation outlining specific steps Congress could take as part of the next stimulus package to help ensure access to affordable, comprehensive care for Pennsylvanians during this vulnerable time.

Commissioner Altman called on the federal government to provide funding to mitigate premium increases for 2021 health insurance products, as insurer filing deadlines for those products are now approaching. To help provide stability to the insurance market during these uncertain times, she urged the implementation of a reinsurance program sponsored by the federal government to cover a proportion of high-cost claims, including those for COVID-19. Finally, she requested that Congress consider additional types of risk mitigation programs or commit to covering the cost of a vaccine.

The commissioner also requested flexibility in the advance premium tax credit reconciliation process for the 2020 plan year to account for income fluctuations due to layoffs and job losses during this unprecedented public health crisis. This could be accomplished by forgiving excess credit or limiting the amount of excess the consumer must pay back.

The commissioner went on to detail several other actions that Congress could take to provide financial help to consumers during these difficult times, including:

  • Addressing the so called “Family Glitch” in the Affordable Care Act that prevents families from qualifying for premium tax credits
  • Subsidizing Consolidated Omnibus Budget Reconciliation Act (COBRA) premiums until the end of the 2020 plan year
  • Passing balance billing legislation to protect consumers from surprise medical bills
  • Instituting a special enrollment period for the federal marketplace allowing uninsured Americans an opportunity to purchase comprehensive health coverage

Finally, is the federal government reacts and adapts to COVID-19 and its consequences, policy changes are happening quickly and the commissioner stressed the need for the federal government take extra steps to ensure that the public is aware of what coverage options are available so Pennsylvanians and others can make the best decisions for their individual circumstances.

Last week, the American Hospital Association—in conjunction with America’s Health Insurance Plans, the American Medical Association, and the U.S. Chamber of Commerce—issued a joint letter to lawmakers urging them to focus on coverage as they consider the next steps to combat COVID-19.

In particular, the group called for efforts to maintain private health benefits for individuals and families, including:

  • Providing employers with temporary subsidies to preserve health benefits
  • Covering the cost of coverage through the COBRA
  • Expanding the use of Health Savings Accounts
  • Opening a Special Enrollment Period for Health Insurance Marketplaces
  • Increasing eligibility for federal subsidies for the Health Insurance Marketplaces

Earlier this month, HAP issued a report that predicts that as the economy erodes and unemployment rises, millions across the country may lose their health insurance coverage or will become unable to pay their premiums, shifting from private insurance to Medicaid and uninsured. That report also estimated that COVID-19’s toll on Pennsylvania hospitals could exceed $10 billion.

Despite previous requests from multiple states, including Pennsylvania, the Trump Administration decided against reopening the Affordable Care Act enrollment to uninsured Americans during the coronavirus (COVID-19) pandemic.

The Pennsylvania Insurance Department and the Pennsylvania Department of Human Services reminded Pennsylvanians that who experience certain major life changes, including the loss of employer-based health care coverage in conjunction with a job loss, are eligible to enroll in health insurance on the federal exchange. Information about these Special Enrollment Periods are available and the insurance department’s website and at HealthCare.gov.

For questions or more information, please contact Jolene Calla, Esq., HAP’s vice president of health care finance and insurance.

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