Increasing access to high quality, affordable coverage
Protecting patients from unfair practices when seeking care
In an complex and difficult-to-navigate healthcare system, patients often encounter unfair practices that make it difficult to find coverage or impose an unreasonable cost burden on patients. As our healthcare system changes and consolidates, PHAN is working to ensure Pennsylvanians have strong protections from these practices.
If you’ve personally dealt with an unfair bill, denial of coverage, or other insurance issue, contact our helpline at 877-570-3642.
Below are our specific policy priorities related to protecting patients:
Surprise Medical Bills
Surprise medical billing is a practice that occurs when patients are billed for the balance of the cost of care that wasn’t covered by their insurance. Importantly, patients are typically not aware that they received care that wasn’t covered by their insurance policy. PHAN is working to advance legislation that would ban this practice, keeping patients out of the middle while plans and providers resolve the issue.
Click here to see our policy briefing.
Click here to share your experience dealing with surprise medical bills.
ACA Protections in State Law
The Affordable Care Act (ACA) ushered in significant changes that protected patients: insurers could no longer deny individuals coverage based on pre-existing conditions, charge higher premiums based on health status or gender, or exclude coverage for essential services. Although these protections still stand, recent policy changes by the Administration and Congress have undermined these protections. As the primary regulators of insurance markets, states have the power to secure the ACA’s consumer protections.
Consolidation and Expansion in Our State
When insurers and healthcare providers in our state expand, consolidate, or make decisions that impact local communities, patients’ needs should be carefully examined and protected. PHAN acts as a watchdog to ensure patients’ needs are being met.
Learn more about how patients are being impacted by the break-up of Highmark and UPMC in Western Pennsylvania.