Governor Wolf Receives Conditional Approval from Federal Government to Pursue State Based Health Insurance Marketplace

June 16, 2015

Harrisburg, PA – Governor Tom Wolf today announced that the Centers for Medicare and Medicaid Services (CMS) conditionally approved the administration’s application to create a Supported State Based Marketplace. This is a critical step in the governor’s contingency plan to protect approximately 382,000 Pennsylvanians in case the United States Supreme Court rules that people are not eligible for subsidies to help them afford health coverage in states where the federal government runs the health insurance marketplaces.

“I am pleased the federal government stands ready to allow Pennsylvania to move forward to protect 382,000 of our citizens from potentially losing subsidies that help them afford health care coverage,” said Governor Wolf. “This conditional approval is another critical step in my contingency plan to set up a Supported State Based Marketplace to ensure Pennsylvanians do not lose coverage in the event of an adverse Supreme Court ruling.”

Conditional approval of Pennsylvania’s application continues Governor Wolf’s contingency plan to protect Pennsylvanians from the possible loss of critical health insurance subsidies. At the beginning of May, the Governor sent a letter to the federal Department of Health and Human Services, declaring Pennsylvania’s intent to implement a Supported State Based Marketplace, in the event the Supreme Court rules people in states such as Pennsylvania, where the federal government runs the health insurance marketplaces, are not eligible for subsidies to help them afford health care coverage.  On June 1, the Wolf Administration submitted an application for review by CMS to continue the process of developing a contingency plan.

“I am committed to protecting hard working Pennsylvanians and making sure they don’t lose the assistance they need to afford health coverage,” Governor Wolf said. “While this conditional approval by the federal government does not mean that Pennsylvania must set up a State Based Marketplace, we are now in a better position to provide security to those who may lose their subsidies, and possibly, not be able to afford their health insurance. I look forward to working with the Legislature to authorize a State Based Marketplace if it becomes necessary.”

One of the factors cited by CMS in its conditional approval of Pennsylvania’s application is the need for the state to comply with federal regulations, which require, among other things, the state to authorize the creation of a State Based Marketplace.

Governor Wolf’s actions come as the Supreme Court prepares to rule on King v. Burwell, a case arguing people in states where the federal government runs the health insurance marketplaces are not eligible for subsidies to help afford coverage.

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