Pennsylvania Health Insurance

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More than half of Pennsylvania’s residents get their health insurance through their employer. While 53% of the state’s population is covered under a group plan, 11% are uninsured, 31% are covered through Medicare or Medicaid and only 5% purchase individual medical plans through private insurers. Many folks also have Pa Medigap plans. The Henry J.Kaiser Family Foundation reported these statistics this month.

Some additional interesting statistics regarding healthcare coverage in Pennsylvania:

61.1% of employers offer coverage to their workers.

98.0% of  employers with more than 50 employees offer benefits.

46.7% of employers with less than 50 employees offer benefits.

29.7% of children between the ages of 10 and 17 are morbidly obese, obese or overweight.

81.5% of children with emotional or behavioral problems  were able to receive mental health treatment.

26.4% of children between the ages of 10-17  have current oral health problems.

79% of children between 19 and 35 months are fully immunized for vaccinations.

78.9% of children under age 18 have had a medical AND dental preventive exam within the last year.

62.6% of adults over age 65 have had a flu shot within the last 12 months.

22.4% of adults are smokers.

23.5% of adult males smoke.

21.5% of adult females smoke.

21.2% of adult Whites smoke.

28.7% of adult Blacks smoke.

59.7% of smokers attempt to quit.

64.5% of adults are overweight or obese.

72.3% of adults visited a dentist within the last 12 months.

71.2% of adults have had their teeth cleaned within the last 12 months.

(Special thanks to Kaiser Foundation for statistics)

Will Obamacare Help Or Hurt Keystone State Residents?

What shouldn’t be lost in all of these numbers, is the impact that the “Affordable Care Act” (Obamacare) is going to have on our residents. We know premiums will be increasing, but by how much? How many insurance companies will decide to avoid the State Exchange and severely limit  the number of private medical plans they offer? Will you truly be able to keep your existing plan, and will your physicians, specialists, and hospitals remain “in-network” next year?

We will provide updated rules, regulations and changes to your Pennsylvania health insurance coverage and review how you can take advantage of new changes including federal tax subsidies for individuals, families and businesses. We expect several new carriers to enter the Marketplace, and inevitably, because of too many claims, many other companies to simply stop offering private plans in the state. Check back in 2017 or 2018.


It’s a bit early to study any new statistics. But there is one trend that seems to have emerged. Of course, Open Enrollment for the new Marketplace plans require no medical questions to be answered. But the percentage of smokers that are applying for coverage is much lower than expected.

Perhaps the reason is the lack of verification of tobacco usage. Since the penalty for smoking is now fairly modest, there appears to be less incentive to disclose this information when enrolling for new coverage. At the end of the year, it will be interesting to see the difference in smokers.

Additional statistical data is provided by Kaiser that is more current. Some of the topics include demographics, mortality, medical school graduates by race and ethnicity, insurance market competitiveness, and voter registration.