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How Has the Affordable Care Act Helped Pennsylvania?

March 23, 2015

Assessing the Law’s Impact after Five Years

HARRISBURG, PA – Today marks five year anniversary of the Patient Protection and Affordable Care Act becoming law. Erin Ninehouser, Policy Director of the Pennsylvania Health Access Network released the following statement to reflect on the law’s impact on the Commonwealth:

“The Affordable Care Act set out to repair the biggest cracks in the foundation of our health care system; to give new options and new hope to folks who had been shut out or priced out of the market for far too long — and those are the people that our organization has worked with and advocated for for years. After five years with the health care law — and two years of open enrollment — the evidence is clear that the law is working.

As part of a federally-funded consortium, PHAN employs Navigators and Certified Application Counselors across the state who are available evenings, weekends, and during normal business hours to help individuals and families apply for health insurance affordability programs like the Marketplace (healthcare.gov), Medicaid, and CHIP. 

In this past Open Enrollment Period, from November 15th to February 15th, PHAN enrolled 1,300 individuals in health coverage — 65% of them in Medicaid, now that eligibility has been expanded. Last year, during the first Open Enrollment Period, PHAN enrolled 1,500 people — 87% of them in plans through healthcare.gov. In total, our enrollment assisters have connected nearly 3,000 Pennsylvanians with health insurance and educated nearly 42,000 about new options available under the ACA. 

Our enrollment work has taken us to American Legion posts in small towns like Central City, Somerset County, to homeless shelters in Lancaster, to worksites like the Durham bus company in Philadelphia. We see everyday the struggles Pennsylvanians have had with finding and keeping health insurance. Before the ACA, there was so little we could do to help people get covered: prices were so high in the individual market, insurers had the power to deny people if they’d been sick in the past, or charge women more than men, and the stringent rules for Medicaid eligibility kept so many low-income people from getting help. 

It’s been a joy for us to finally be able to connect Pennsylvanians with health insurance that they can count on to cover the services they need to keep themselves and their families well. 

Prior to the law, 1.2 million Pennsylvanians were uninsured. Today, thanks to the Affordable Care Act, that number has been cut in half. Most recent figures from the Department of Health and Human Services show that after this most recent Open Enrollment Period:

In addition, 600,000 Pennsylvanians with lower incomes are newly-eligible for coverage through an expansion of Medicaid, which began January 1st of 2015. That means individual and families making less than 138% of the federal poverty level can now qualify for free, comprehensive health insurance that covers doctor and specialist visits, preventive care, hospitalization, prescription medicines, and mental health treatment. 

To learn more or find out if you qualify, folks can visit www.healthchoicespa.com or call our enrollment assisters at 1-877-570-3642. Enrollment for Medicaid and CHIP are open year-round.

Nationally, 16 million Americans gained access to health insurance under the Affordable Care Act. States that fully implemented the law and didn’t hold up an expansion of coverage to lower-income residents, like Pennsylvania did under Governor Corbett in 2014, saw the biggest gains in coverage. 

But expanding coverage to the uninsured is only one part of what the Affordable Care Act does. The law also protects those who were already covered by: 

  • Making sure at least 80 cents of every premium dollar we spend goes to medical care, rather than advertising, lobbying and executive salaries;
  • Allowing young adults to stay covered on their parents’ insurance until they turn 26 — which helped 91,000 young adults in Pennsylvania;
  • Barring insurers from restricting your family’s care by imposing lifetime limits on coverage — an important protection for more than 4.5 million Pennsylvanians with private insurance;
  • Requiring all new insurance plans to cover preventive services like mammograms, colonoscopies and contraceptives without a co-pay; and
  • Closing the “Donut Hole” gap in Medicare prescription drug coverage by putting in place new discounts (55% on brand name medicines, and 35% on generics) for seniors who fall into that gap — in Pennsylvania, this has saved seniors more than $732 million on prescriptions, an average of $767 per person.  

Our message to folks that didn’t enroll in 2014 and who aren’t covered today is this: Take a look at your options! 8 in 10 Pennsylvanians who got covered through the Marketplace are getting financial help to lower their monthly premiums. Competition has increased the number of plans available, prices are affordable, and there’s free, in-person enrollment assistance available to help folks find a quality plan that will meet their needs and budget. You can go to www.pahealthaccess.org/GetHelp to connect with a Navigator or Certified Application Counselor in your community, or call PHAN’s Helpline at 1-877-570-3642.”