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Access to Care

Health Care Reform

Pennsylvania hospitals support efforts to ensure coverage for all individuals. The framework established under the Affordable Care Act (ACA)—which offers subsidized coverage through health care insurance exchanges, combined with expanded access to Medicaid—provides the most viable pathway to expand coverage and reduce costs.

  • More than 1.1 million Pennsylvanians have benefited from access to coverage
  • Millions have benefited from consumer protections—coverage for pre-existing conditions, no lifetime limits, a minimum essential benefits package

HAP has produced an interactive state map to help the public and policymakers understand the Affordable Care Act’s health care coverage impact in the state’s Congressional districts.

In Pennsylvania, the ACA’s individual and small group health insurance plans remain stable. For 2019, in aggregate, individual plans will show a 2.3 percent rate decrease statewide and an average 2.6 percent increase for small group market plans. All but ten of Pennsylvania’s counties have more than one insurer offering coverage and additional insurers are joining the individual market in 30 Pennsylvania counties.

Despite those successes, the Administration and some members of Congress have challenged the law. There is increasing conversation about proposals that would upend the existing health care system by establishing a government-run, single-payer, universal Medicare program.

In light of the uncertain political environment, HAP has embraced a multi-faceted strategy to advocate for affordable, comprehensive coverage for as many Pennsylvanians as possible, and protection for access to care for everyone.

Efforts include:

  • Promoting insurance enrollment by partnering with the Pennsylvania Insurance Department to convene stakeholders to implement education and outreach strategies
  • Maintaining coverage gains by working with the state Congressional delegation and federal policymakers to maintain comprehensive health coverage and oppose Administrative policies that weaken coverage provisions
  • Supporting the Wolf Administration’s commitment to enforce consumer protections provided through the ACA, and to nurture a viable and stable insurance market 

As federal policymakers push alternative approaches to the ACA framework, including a single-payer model, the issues will require extensive conversation and attention

  • Disruption to employer-sponsored coverage
  • Access concerns that would stem from expanding reliance on public programs. Medicare and Medicaid have historically reimbursed providers less than the cost of care
  • The threat of decreased payment rates through the micro-management of Medicare and Medicaid, driven by politicians who are under pressure to address costs
  • Stifling of delivery system reforms that have improved care, enhanced quality, and reduced costs

HAP will continue to partner with federal and state officials, and health care stakeholders to maintain and expand access to meaningful coverage and high quality care.

ACA IMPACT – INFORMATION AND RESOURCES

HAP President and CEO Andy Carter Letter to Pennsylvania Delegation (Download PDF) - March 2017 PA Health Care Providers Letter to Pennsylvania Congressional Delegation ( Download PDF) - May 2017
AHA Letter to Members of Congress on AHCA (Download PDF) - February 2017
Report Card Health Care Transformation in PA (Download PDF) - February 2017

Related News

Coverage Proposals Examined in U.S. House Hearing; Hospitals Advocate to Build on Progress in Expanding Access to Comprehensive Coverage by admin

In the face of strong public attention to the affordability of health care and political interest by Democrat Presidential hopefuls in a single-payer regime in which government operates a tax-funded health insurance plan for all residents, in a hearing this week, the U.S. House Ways & Means Committee explored policy options to expand access to health coverage.

With National Eyes on Innovative Rural Health Model, Senate Takes Key Vote by admin

Today, legislation aimed at improving the financial stability of rural hospitals gained unanimous support from the Pennsylvania Senate and was sent to the House of Representatives for consideration.​ Senate Bill 314, sponsored by Senator Lisa Baker (R–Luzerne), would establish the Pennsylvania Rural Health Redesign Center (RHRC), which would serve as the governing body of the new Rural Health Model, which began January 1, 2019, and was formally announced during March.

HAP-Supported Nurse Practitioner Bill Passes Senate by admin

HAP-supported Senate Bill 25 was voted on today by the full Senate. Sponsored by Senator Camera Bartolotta (R-Washington), the bill allows certified nurse practitioners (CNP) to practice to the full scope of their license without the need for physician supervision after they have worked under such supervision for three years and 3,600 hours.

Pennsylvania’s Tobacco Settlement Money Remains at Risk; Act Now by admin

As efforts to pass a state budget by the June 30 deadline heat up, some lawmakers still want to use money from the Pennsylvania Tobacco Settlement Fund to pay state debt payments. Email your lawmaker now, telling them that all Tobacco Settlement Money should continue to support health care.

Opinion: In PA, health won out over big tobacco, but it could lose in this year’s budget. by Rmoore@haponline.org

In this opinion column, HAP President and CEO Andy Carter addresses the importance of preserving Tobacco Settlement Fund resources for health care.

Latest PHC4 Report Suggests Stabilization of Neonatal Abstinence Syndrome Rates in PA by Rmoore@haponline.org

According to a new report from the Pennsylvania Health Care Cost Containment Council (PHC4), rates of neonatal abstinence syndrome (NAS) could be plateauing in Pennsylvania, a sign that efforts to curb the opioid crisis may be helping.

PA House Considers Plan to Authorize State Takeover of Health Insurance Marketplace by Rmoore@haponline.org

Five years after the implementation of the Affordable Care Act (ACA), Pennsylvania lawmakers are considering a plan to allow the state to take over the health insurance marketplace.

Legislation to Bolster Rural Hospitals Clears Key Committee Vote by Rmoore@haponline.org

Today, legislation aimed at improving the financial stability of rural hospitals gained unanimous support from the state Senate Health and Human Services Committee.

Pennsylvania House Adopts Resolution Authorizing Study of State’s Behavioral Health Needs by Rmoore@haponline.org

This week, the state House of Representatives unanimously adopted a resolution to help lawmakers better understand the behavioral health needs of Pennsylvania’s patients, beginning with the impact of behavioral health holds in emergency departments. 

U.S. Supreme Court Affirms Hospital Position in Allina Case by Rmoore@haponline.org

In a ruling with significant procedural implications for the implementation of the Medicare Act, the U.S. Supreme Court today affirmed the importance of allowing an opportunity for stakeholders to comment on proposed rules through notice-and-comment rulemaking relative to the Medicare Disproportionate Share Hospital (DSH) program, which provides resources for hospitals that serve a high volume of low-income patients.

Related Blogs

Coverage Proposals Examined in U.S. House Hearing; Hospitals Advocate to Build on Progress in Expanding Access to Comprehensive Coverage by admin

In the face of strong public attention to the affordability of health care and political interest by Democrat Presidential hopefuls in a single-payer regime in which government operates a tax-funded health insurance plan for all residents, in a hearing this week, the U.S. House Ways & Means Committee explored policy options to expand access to health coverage.

With National Eyes on Innovative Rural Health Model, Senate Takes Key Vote by admin

Today, legislation aimed at improving the financial stability of rural hospitals gained unanimous support from the Pennsylvania Senate and was sent to the House of Representatives for consideration.​ Senate Bill 314, sponsored by Senator Lisa Baker (R–Luzerne), would establish the Pennsylvania Rural Health Redesign Center (RHRC), which would serve as the governing body of the new Rural Health Model, which began January 1, 2019, and was formally announced during March.

HAP-Supported Nurse Practitioner Bill Passes Senate by admin

HAP-supported Senate Bill 25 was voted on today by the full Senate. Sponsored by Senator Camera Bartolotta (R-Washington), the bill allows certified nurse practitioners (CNP) to practice to the full scope of their license without the need for physician supervision after they have worked under such supervision for three years and 3,600 hours.

Pennsylvania’s Tobacco Settlement Money Remains at Risk; Act Now by admin

As efforts to pass a state budget by the June 30 deadline heat up, some lawmakers still want to use money from the Pennsylvania Tobacco Settlement Fund to pay state debt payments. Email your lawmaker now, telling them that all Tobacco Settlement Money should continue to support health care.

Opinion: In PA, health won out over big tobacco, but it could lose in this year’s budget. by Rmoore@haponline.org

In this opinion column, HAP President and CEO Andy Carter addresses the importance of preserving Tobacco Settlement Fund resources for health care.

Latest PHC4 Report Suggests Stabilization of Neonatal Abstinence Syndrome Rates in PA by Rmoore@haponline.org

According to a new report from the Pennsylvania Health Care Cost Containment Council (PHC4), rates of neonatal abstinence syndrome (NAS) could be plateauing in Pennsylvania, a sign that efforts to curb the opioid crisis may be helping.

PA House Considers Plan to Authorize State Takeover of Health Insurance Marketplace by Rmoore@haponline.org

Five years after the implementation of the Affordable Care Act (ACA), Pennsylvania lawmakers are considering a plan to allow the state to take over the health insurance marketplace.

Legislation to Bolster Rural Hospitals Clears Key Committee Vote by Rmoore@haponline.org

Today, legislation aimed at improving the financial stability of rural hospitals gained unanimous support from the state Senate Health and Human Services Committee.

Pennsylvania House Adopts Resolution Authorizing Study of State’s Behavioral Health Needs by Rmoore@haponline.org

This week, the state House of Representatives unanimously adopted a resolution to help lawmakers better understand the behavioral health needs of Pennsylvania’s patients, beginning with the impact of behavioral health holds in emergency departments. 

U.S. Supreme Court Affirms Hospital Position in Allina Case by Rmoore@haponline.org

In a ruling with significant procedural implications for the implementation of the Medicare Act, the U.S. Supreme Court today affirmed the importance of allowing an opportunity for stakeholders to comment on proposed rules through notice-and-comment rulemaking relative to the Medicare Disproportionate Share Hospital (DSH) program, which provides resources for hospitals that serve a high volume of low-income patients.

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