How Pennsylvania Will Fight to Protect Health Insurance and Treatment for Substance Use Disorders

By: Governor Tom Wolf

January 11, 2017

In December 2016, Majority Leader McCarthy and other members of United States House of Representatives’ Republican leadership requested input and recommendations from governors and insurance commissioners on potential health care reforms under the next administration.

A few weeks ago, I provided my response and made one thing clear: Pennsylvanians need good, affordable health care options and they cannot be asked to undergo a lapse in coverage.

Here’s what we know:

  • U.S. Census data shows that the commonwealth’s uninsured rate has dropped from 10.2 percent in 2010 to 6.4 percent in 2015.
  • In 2016, more than 439,000 Pennsylvanians had selected health coverage through the Marketplace. Seventy six percent of those Pennsylvanians received subsidies to make those plans more affordable and 60 percent of those enrollees could obtain coverage for $100 or less after tax credits.
  • After expanding Medicaid in February 2015, more than 690,000 Pennsylvanians have enrolled in HealthChoices, Pennsylvania’s mandatory managed care Medicaid program.
  • In the first year of Pennsylvania’s Medicaid expansion, almost 63,000 newly eligible Medicaid enrollees accessed drug and alcohol treatment. This coverage is essential in battling the opioid and heroin public health crisis that took over 3,500 lives in Pennsylvania in 2015.

The ACA is not perfect. But as we talk about changes to the health care system, we must protect the following:

  • Affordability. We must address rising health care costs in order to improve health insurance affordability long-term. It is critical to curb prescription drug costs, incentivize value over volume when accessing and paying for care, and increasing transparency of health care costs to help consumers make empowered buying decisions as ways that could help rein in health care spending.
  • Ban on Lifetime Limits. It is critical that we protect the ACA’s ban on lifetime limits to ensure that consumers are able to access robust and comprehensive health insurance coverage that does not put individuals with chronic or catastrophic conditions in dangerous financial positions.
  • Coverage for those with Pre-existing conditions. Prohibition on exclusions due to pre-existing conditions is a crucial consumer protection aspect of the ACA that allows those with chronic or catastrophic conditions to receive the treatment they need without going bankrupt. A recent study by the National Center for Health Statistics also found that that the number of people whose families currently struggle to pay medicals bills has declined by 22 percent or by 13 million people over the last five years.
  • Access to free preventive services. Allowing consumers to access regular doctors’ visits and screenings that can help manage and identify potential health issues before they become more advanced and costly is vital to all Pennsylvanians.

To read my response, click here.

To read Pennsylvania Insurance Commissioner Teresa Miller’s letter in full, click here.

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