Posts Tagged ‘Pa health care reform’

Health Care Reform in Pa And Impact On Prices

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Pennsylvania health insurance reform is coming. But if House Speaker Nancy Pelosi has her way, you can expect to see your Pa rates for medical coverage rise faster than you ever imagined. However, there are some alternative solutions that will cost less, expand coverage, and improve quality. Some of these ideas have been discussed and others are active in other states but not here in our state.

Five reform ideas that should be implemented (courtesy of Douglas Holtz-Eakin and Paul Howard) are:

1.     Eliminate the federal tax exclusion and replace it with a tax deduction or instant tax credit. Typical savings could be used to reduce the cost of individual and family policies. Everybody would benefit by receiving quality coverage at a reduced cost. Many carriers would be available in all areas.

2.     Increase and expand funding to high-risk plans so that major pre-existing conditions would be better covered. Currently, these “pools” are doing well, and by making them stronger, healthier persons may see their costs go down. By promoting wellness, long-term rates may slightly reduce, since the most costly types of surgeries and medications would decrease. Insurers could offer special inducements to customers for taking annual physicals on a regular basis.

3.     Let health insurance companies sell coverage across state lines. If Pennsylvania consumers do not want or need expensive “Cadillac”  plans with features they will never use, why force them to buy these plans? Maybe they could get cheaper plans elsewhere. This idea won’t make a substantial difference for most people, but it makes sense to have the option available. Highmark could market plans in Ohio, and Medical Mutual could offer coverage in the Keystone State.

4.     Eliminate waste, abuse and fraud in the Medicare and Medicaid programs. Fraudulent activities cheat taxpayers out of billions of dollars each and every year, including many in Pennsylvania. Let’s take on this problem  before revamping the entire  system. Easily, hundreds of millions of dollars could be saved annually, with that money more efficiently utilized.

5.     Enact tort reform that will end lawsuit abuse. This change would reduce the federal budget deficits by approximately $54 billion over the next 10 years. And that’s better than the ideas we have been hearing from Washington DC. A lot better.

Health Care Reform In Pa


As the owner and founder of this website, Pennsylvania’s leading resource for affordable healthcare, I sincerely support reform. But let’s do it the right way. Let’s not offer free insurance to a few and charge everyone else a fortune. Ultimately, this will simply destroy a system that 80% of the population supports.

Let’s also not bankrupt America in the process of enacting this law. I have confidence that the right decisions will be made on behalf of consumers. There seems to be increased understanding of the serious issues that face us.

UPDATES: In a few months, the Supreme Court will rule on the legality of requiring citizens to buy health insurance. I expect a close vote, but it’s too early to predict the outcome. Regardless, we hope that our delivery system stays in the hands of the free market and not elected officials. “The Affordable Care Act” has some great features (including the preventive changes) and parts of it should remain. But many portions of the bill could put excessive strain on our economy.

Another portion of Obamacare we have not discussed is the Pa small business Shop Exchange, which helps small business owners offer quality benefits to their employees. We provide specific rates and details in other portions of our website.

10-22-2012. It’s hard to believe but the election is in less than two weeks. Mitt Romney has seized the momentum in this state and nationally. But it may not be enough. Whatever the outcome, we hope that changes to private medical plans are not made for political reasons. They should be well thought out and investigated, with the consumer’s best interest in mind.

4-20-2013. The election, of course, has been decided and President Obama was re-elected. The Pa Health Exchange/Marketplace will be open in October for 2014 Open Enrollment. You can request to see rates at the top of the page. No word on prices yet, but within the next few months, carriers should release that information.

7-19-2015. Obamacare has survived another Supreme Court challenge in a recent 6-3 decision. Although minor changes, tweaks, and adjustments are needed, and will certainly occur, a major overhaul is very unlikely. The ACA Legislation has helped many persons and hurt many others. But it is here to stay.

10-22-2018 – Oscar will be offering 2019 coverage in the Philadelphia area. Rates have moderately increased, and no major companies have exited the marketplace.

Our job remains the same. We will utilize all available tools and laws to help you find the most affordable health insurance plans in Pennsylvania. In the future, if legislation impacts your benefits, we will review your best options and make the appropriate recommendations.

Your Pa Medical Benefits Will Look A Lot Different

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Medical benefit changes are coming to Pennsylvania. But unless you’re uninsured, you may not see this change until 2013…and perhaps not at all. If President Obama signs and passes an overhaul this fall, some tangible changes may be noticed in about three or four years. But it is still possible that legislation will not be enacted. Most Republicans and a growing number of Democrats do not want government-run healthcare. But that may not matter.

But if the proposed legislation passes, consumers will be waiting a while to see the results. It may take a few years to implement new regulations, and determine if “Marketplaces” will be run by states or the federal government.

Reading And Understanding “The Affordable Care Act”

One reason the bill  may not pass is simply most Americans disapprove of the way the process has been handled. The proposed house legislation would outlaw Pa private health insurance in its present form. Most consumers are not aware of that. But don’t feel bad. The President wasn’t aware of it either! 

In his defense, It would have taken anybody about 6-9 months to read, study and understand the legislation in its entirety. There are many exceptions to rules, and entire sections that are subject to interpretation in many ways.

Learn about Health Insurance Reform In Pa

Pa Health Exchange Plans

So what will ultimately change? Based on my 29 years of experience as an independent broker, I believe that insurance will be mandated (required) and ultimately, companies like Aetna, Keystone and Highmark, will offer coverage to all persons, regardless of medical history.However, there may still be “risk pools” that are able to offer coverage to individuals and families that are either unable to afford or can not qualify for a policy.

But I also believe that the government will leave individual states to largely determine and shape the future of its residents. Rates will stabilize and tax incentives will help offset some of the cost.  The incentives will be in the form of instant tax-credits, which will be largely determined on the amount of money each household earns. Although this will be a short-term solution, it still will not solve the problems we face in the future.


February 2012 –   Wow! A lot has changed since I wrote this blog post in July of 2009. Reform was indeed passed by the Obama Administration (Affordable Health Care Act). And some positive changes have occurred such as 100% preventive benefits now included on most policies.

The Supreme Court will have its say in about three months when they determine the legality of requiring Americans to purchase medical insurance. Stay tuned!

June 2012 –  Tomorrow is the day!

October 2012 –  First of all. Trick or treat! No trick in June as the Supreme Court ruled the mandate legal. What does that mean to you? Not much right now. In 2014, your choices will be limited  as Exchanges begin to operate. You can check our blog and website for the most current information regarding buying or changing your Pa medical plans.

May 2013 –  The Pa Exchange (Marketplace) is going to be ready in October for Open Enrollment. Yes, you can get rates and apply through this website). Despite the many scandals in the White House right now, Obamacare seems safe.

August 2015 – The second Open Enrollment begins on November 1st for 2016 coverage. Surviving a summer Supreme Court challenge, Obamacare continues, although rates continue to climb.