PHAN Responds to SCOTUS Ruling, Next Steps in PA

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PHAN Responds to Supreme Court Ruling:

Supreme Court Decides ACA is Here to Stay, Time for Pa. Policymakers to Get Moving     

Antoinette Kraus, project director for the Pennsylvania Health Access Network, issued the following statement:

“Today’s Supreme Court ruling is a victory for millions of Pennsylvania families, seniors and small business owners. Young adults can remain on their parents’ health plans, insurance companies cannot deny us when we get sick and our grandparents will continue to get help with their prescription coverage.

Millions of Americans have already benefited from the Affordable Care Act and millions more will benefit from additional consumer protections and a new insurance marketplace that will provide affordable health care options to small businesses and families. Nearly 1.3 million uninsured Pennsylvanians will now be able to find quality affordable health coverage.

The Supreme Court has made it clear that the Affordable Care Act is here to stay. It is now time for Governor Corbett and our elected leaders in Harrisburg to get to work implementing the Affordable Care Act in Pennsylvania. All Pennsylvanians deserve to have access to affordable health care that allows them to be healthy and productive members of their communities.”

The Pennsylvania Health Access Network has been working with individuals and families to help them share their health care stories since our inception in 2007. We have people who have benefited from a number of provisions of the Affordable Care Act, living across Pennsylvania, and ready to speak with you. 

Sample Stories

“I’m a senior citizen with Multiple Sclerosis trying to survive on a limited income. I have saved over $7,000 thanks to the 50% discount the Affordable Care Act gives to seniors who fall into the ‘donut hole’ in Medicare Part D. The Affordable Care Act also means that my medical records and prescriptions are electronically available to all my specialists which reduces costs and errors.”

-- Karlene Ellsworth, Eastern Pennsylvania

“My two twins, Hannah and Madeline, were diagnosed with Leukemia at the age of four. To continue growing, they needed to take injections that our insurance company refused to cover. Between doctors visits and the cost of the medication, my husband and I had to file for bankruptcy. The Affordable Care Act sets up an appeals process that will let us seek out a fair appeal when insurance companies try to deny my little girls life-saving treatment. It also means they will be able to stay on their dad’s plan until they are 26 and won’t face discrimination because of their pre-existing conditions. I can’t tell you the relief that brings to a mother!”

-- Stacie Ritter, Central Pennsylvania

“I have a pre-existing condition and all the health insurance companies were either denying me or wanted way more than i could ever afford. I was finally able to get health insurance through PA Fair Care and I love it.”

-- Barb Stakes, Eastern Pennsylvania

“My 23 year old son was diagnosed with Crohn’s disease at age 13. The only way for us to keep it under control is for him to be on several expensive medications. He would be uninsured if he couldn’t stay on our insurance plan until he’s 26. When it’s time for him to find insurance, he won’t be denied due to the preexisting condition and years of treatment he’s already undergone.”

-- Jeannette Trauth, Churchill, PA (Southwest)

“I am one of the underinsured desperately hanging on until 2014. I’m 61 with multiple health conditions. I have an extremely limited insurance plan that only allows 5 doctor visits a year, no specialists, and very limited coverage for hospitalization, tests, etc., but still costs me $300 every month! I’m trying to deal with huge medical bills for care that I absolutely needed, but that my health insurance company refused to cover. In December, I thought I had kidney stones which I’ve had before, so I delayed going to the doctor for as long as I could because I knew I couldn’t handle the bills. I eventually lost all function in my left kidney.”

-- Cathy Matsey, Western Pennsylvania

In addition to the above samples, PHAN has many other folks from across Pennsylvania who have benefited or have hoped to benefit from the Affordable Care Act and can speak about:

  • Looking forward to the Health Insurance Marketplace being established in Pennsylvania
  • Keeping their kids on their plan, including kids with pre-existing conditions
  • Losing a loved one who died only because he didn’t have insurance
  • Benefiting from protections for people with pre-existing conditions
  • Receiving free preventive care from Medicare and benefiting from donut hole discount
  • Benefiting from provisions that help breastfeeding mom

What the Affordable Care Act Has Meant for Pennsylvania

Coverage for young adults

91,000 young adults have been able to obtain coverage through their parent’s plan until the age of 26.

Saving seniors money on prescription drugs

In 2011, Seniors in Pennsylvania on Medicare Part D saved on average $662 per person and a total of $156,108,903 from discounts the Affordable Care Act offers people who fall into the ‘donut hole.’ 

Peace of mind for millions

Millions of Pennsylvanians (approximately 2.3 million under the age of 65) have a pre-existing condition and will benefit from protections against discrimination.  

Saving lives

2 people die every day in Pennsylvania, because they do not have access to health insurance.  The Affordable Care Act is projected to save 7,500 Pennsylvanian lives over the next decade.

Free Preventive Care

In 2011, 1,509,076 people with Medicare in Pennsylvania received free preventive services - such as mammograms and colonoscopies - or a free annual wellness visit with their doctor.  236,300 Pennsylvanians with private insurance also gained preventive service coverage with no cost-sharing.  That number is expected to increase dramatically by 2014.

PA Fair Care

4,567 previously uninsured residents of Pennsylvania who were unable to obtain coverage due to a pre-existing condition entered into a new insurance pool designed by the Affordable Care Act to serve as a bridge until 2014, when discrimination for pre-existing conditions in the private marketplace is banned.

More money for our health centers

Pennsylvania’s health centers have received $34.2 million to expand their services.

Policyholders issued rebate check

To ensure health insurance company spend money on actual health care not on CEO bonuses, lobbying, advertising, administrative costs or other line items unrelated to health care, the new health care law requires insurance companies to spend 80% of your premium money on actual care or issue policyholders a rebate check.  Rebates to be issued this year are expected to average $165 for 312,000 Pennsylvania families.

Abusive practices barred

7.4 million Pennsylvanians with private insurance benefit from new protections against abusive practices such as pulling coverage when the consumer needs it most, issuing lifetime and annual limits, and denying coverage for necessary treatment.