Monday, August 22, 2011

The LuLac Edition #1727, August 22nd, 2011



The Pennsylvania Health Access Network is calling for a state wide health care marketplace that would make consumer health care easier and less costly to obtain.
Pennsylvania should establish a competitive health insurance marketplace that gives consumers more control, quality choices and better protections when buying health coverage, according to the Pennsylvania Health Access Network (PHAN).
PHAN representatives and allies have been weighing in at Pennsylvania Insurance Department hearings on the creation of an insurance marketplace in Pennsylvania.
“A strong health insurance marketplace will open the door to high-quality, affordable health coverage for more than 1 million uninsured Pennsylvanians,” said Antoinette Kraus, PHAN’s project director. “It will allow individuals and small businesses to leverage their collective buying power and drive down costs.
“A competitive, transparent marketplace is good for consumers, good for businesses and good for Pennsylvania,” she added.
Pennsylvania is one of many states considering the creation of an insurance marketplace. States must establish insurance marketplaces, or exchanges, by 2014 under the Affordable Care Act or allow the federal government to create one for them.
The marketplace will feature an easy-to-use web site allowing people to compare health insurance plans to find one that meets their needs and budgets. It will also connect consumers with federal assistance to purchase coverage.
The marketplace is purely voluntary for people who lack insurance, have lost their coverage or are unhappy with the policy they have. Those who are satisfied with their insurance can keep it. Small businesses can use the marketplace to purchase affordable health coverage for their employees.
Pennsylvania’s Insurance Commissioner hosted a hearing today in King of Prussia —the second of three hearings across the state to gather community input on creating an insurance marketplace. A hearing was held earlier this week in Western Pennsylvania.
Two of PHAN’s partners offered testimony at today’s hearing. Kristen Dama, a Staff Attorney with Community Legal Services, urged the state to move forward with a Pennsylvania insurance marketplace.
"We are very happy that Pennsylvania is taking these important first steps to implement the Affordable Care Act, and we hope that it will ensure that the interests of both public and private health insurance consumers are protected as it moves forward," Dama testified.
Last year, nearly half of working age women in this country skipped needed health care because they could not afford it, according to a new report from the Commonwealth Fund. This means that 45 million women could not afford to fill their prescriptions, get recommended medical tests or go to the doctor when they had a medical problem, said Rebecca Foley, Director of Public Policy for Women’s Way and a member of the PHAN Policy Committee.
“A Pennsylvania health insurance marketplace will result in tremendous gains for women at the same time providing Pennsylvania families, small businesses and individuals with more control, better choices and greater protections," Foley said.
1. The marketplace should be competitive and consumer-driven.
The marketplace should have a governing board that includes patient voices, small businesses and insurance experts who don’t work for the industry to ensure that it makes smart decisions to improve quality and efficiency. The board should have the authority to negotiate with insurance companies to secure the best prices for consumers and to protect consumers against insurer abuses, like denial of care or unjustified rate hikes.
2. The marketplace should be accountable, transparent and easy to use.
The marketplace should use clear, jargon-free language to describe insurance plans and provide well-trained “navigators” who can help individuals and families decide which coverage option is best for them. To protect against conflicts of interest, the governing board should exclude any insurance industry representatives and brokers that stand to profit from enrollment in the marketplace.
3. The marketplace should provide high-quality affordable health care options.
The marketplace should adhere to strict quality standards and prevent insurers from raising premiums unreasonably. The marketplace will also be tasked with providing income-based tax credits to working and middle-class families. As such, it should ensure that all eligible individuals and families are protected financially by limiting co-payments, deductibles and other cost-sharing based on a family’s income.
The Insurance Department will hold its third and final insurance marketplace hearing on August 23 in Harrisburg. PHAN is encouraging consumers to attend that meeting, if possible, to make their voices heard.
The Pennsylvania Health Access Network (PHAN) is a coalition of 50 groups from across the Commonwealth working to improve access to quality health care through the expansion of health insurance coverage. To learn more, go to
EDITOR'S NOTE: Here's a link to PHAN's phone meetings. Check this out if you have questions about health care in Pennsylvania.


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