Harrisburg, PA – Governor Tom Wolf today outlined a contingency plan to protect 382,000 Pennsylvanians from losing subsidies that help them afford health insurance coverage. Governor Wolf sent a letter to the federal Department of Health and Human Services declaring Pennsylvania’s intent to implement a PA state-based marketplace for Pennsylvanians to shop for health insurance coverage in the event 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.
“In order to protect 382,000 Pennsylvanians from potentially losing subsidies that help them afford health care coverage, I have written to the federal government outlining a contingency plan to set up a state-based marketplace to ensure no one loses their health coverage,” said Governor Wolf. This is the first step in protecting hardworking Pennsylvanians from losing the assistance they rely on to purchase health care coverage in the event the Supreme Court rules that in states where the federal government runs the marketplace people are not eligible for subsidies. My letter does not mean that Pennsylvania must set up a state-based marketplace. However, it would be irresponsible not to have a plan in place to protect 382,000 people. I look forward to working with members of the legislature to advance this plan if necessary.”
Governor Wolf’s letter to the Department of Health and Human Services does not mean that Pennsylvania has to set up a state-based marketplace. The governor’s letter also does not mean that Pennsylvania must submit an application, nor does it mean that the state will be transitioning to a state-based marketplace. This simply leaves the door open so the state has this option in the event of an adverse Supreme Court ruling.
Governor Wolf’s action comes as the Supreme Court is expected to rule in late June on King v. Burwell, a lawsuit arguing that people in states where the federal government runs the health insurance marketplaces are not eligible for subsidies to help them afford coverage. In Pennsylvania, about 382,000 people are receiving subsidies in 2015, and the Kaiser Family Foundation estimates that 736,000 people could be enrolled in subsidized coverage in 2016.
Below is the full text of Governor Wolf’s letter to the Department of Health and Human Services:
The Honorable Sylvia Burwell
Secretary of Health and Human Services
Department of Health and Human Services
200 Independence Ave SW
Washington, DC 20201
Dear Secretary Burwell,
Please accept this letter as Pennsylvania’s declaration to implement a State Based individual and SHOP Marketplace (“Marketplace”) using the federal platform for plan year 2016.
In this model, Pennsylvania will assume responsibility for running the Marketplace, but will leverage the Federally Facilitated Marketplace’s (FFM’s) existing infrastructure to provide certain services. Pennsylvania will continue to work closely with the Center for Consumer Information and Insurance Oversight (CCIIO) to prepare the State Based Marketplace blueprint application and define the roles and responsibilities of the State Marketplace and the FFM.
The Commonwealth designates the Acting Commissioner of the Pennsylvania Insurance Department, Teresa Miller, as the primary point of contact regarding the Marketplace. Commissioner Miller is authorized to formally bind the Commonwealth regarding the Marketplace, complete and sign the Marketplace application, and electronically attest to the facts in the Marketplace application. Pennsylvania acknowledges that the Department of Health and Human Services (HHS) and the Commonwealth may agree to amend this declaration letter to include additional information necessary to establish the Marketplace.
Pennsylvania is committed to working with HHS, CCIIO, and stakeholders in the Commonwealth to implement a streamlined Marketplace that will be tailored to local needs, run in a fiscally responsible manner, and overseen by state regulators, who can use their decades of experience regulating the Pennsylvania insurance market to build on the FFM’s work improving health insurance access, quality, transparency, and affordability. Pennsylvania supports your efforts to transform payment for health care services from volume to value. The Commonwealth will be working with health insurance companies participating in the marketplace to identify goals that mirror those articulated by the federal government in this area.
Thank you for your continued support in this important undertaking.
MEDIA CONTACT: Jeff Sheridan – 717.783.1116
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