Pennsylvania: Let's check in on "Pennie", PA's state-based ACA exchange...

Mon, 07/20/2020 - 1:07pm

Between the COVID-19 pandemic and just getting generally swamped, I haven't gotten around to writing about Pennsylvania's state-based ACA exchange, due to launch this fall, since way back in December:

PA’s A Step Closer To Starting A State-Based Health Insurance Exchange

Pennsylvania’s new, state-run health insurance exchange is getting rolling ahead of its launch in 2021.

The commonwealth has chosen a California-based company, GetInsured to run it.

...Zachary Sherman, who heads the newly-created Pennsylvania Health Insurance Exchange Authority, said the contract with GetInsured will cost around $25 million annually, plus startup expenses that’ll be spread over several years.

“That’s compared to what we currently pay for Healthcare.gov, which is in the $90 to $95 million range,” he said.

Sherman said the administration chose GetInsured because it has already contracted with other states, like Nevada and Minnesota.

He said the new exchange is expected to save people between five and ten percent every year on premiums.

Pennsylvania's move to their own full ACA exchange seemed to happen very quickly last year, with an unusual amount of bipartisan support, but the reality is that Democratic Governor Tom Wolf has been pushing to implement one since as far back as the infamous King v. Burwell lawsuit days of 2015.

Regular readers may recall that Pennsylvania expects to pay their share of their new Section 1332 Reinsurance Waiver program using the ~$60 million or so which they expect to save from moving off of HealthCare.Gov onto their own exchange platform. It's a clever funding mechanism which, in the end, amounts to simply "passing the savings along to the customers", so to speak; that $60 million in savings is leveraged with $145 - $190 million in federal reinsurance dollars to reduce unsubsidized premiums for Pennsylvania ACA enrollees by around 5-10%. This isn't the most robust reinsurance program in the country, but hey, 5-10% isn't chump change either.

In any event, as always, Louise Norris has the skinny on "Pennie":

The website will debut in late August, and Pennsylvania residents will use Pennie (instead of HealthCare.gov) to enroll in coverage for 2021 once open enrollment starts on November 1, 2020. As noted above, the enrollment window will continue through January 15, 2021, giving Pennsylvania residents an additional month to sign up for coverage.

Interesting. I figured they'd stick with the official federal deadline for the first year, as Nevada did when they split off from the federal exchange last fall. Fair enough.

As of June 2020, the exchange has a full-time staff of 19 people and is beginning a second hiring wave. The system is undergoing the various testing procedures that are necessary in order to ensure a seamless transition in the fall. The Pennsylvania Insurance Department is maintaining a page devoted to the creation of the state-run exchange, which includes links to all of the board meeting and advisory committee meeting minutes.

...In August 2019, Governor Wolf announced the appointees for the Pennsylvania Health Insurance Exchange Authority’s board of directors. The group is overseeing the implementation and operations of the state-run marketplace. And Zachary Sherman, who previously served as the director of Rhode Island’s health insurance exchange, is leading Pennsylvania’s exchange.

...Pennsylvania already switched to having a state-based exchange on the federal platform (SBM-FP) as of the fall of 2019. This means Pennsylvania is responsible for a variety of exchange functions and oversight, but uses HealthCare.gov for enrollment (five other states have the same exchange model).

...In addition to financial savings, states that run their own exchanges also have flexibility regarding their open enrollment schedules (Pennie’s first enrollment window will continue until January 15, 2021, which is an extra month beyond what it would be if the state had continued to use HealthCare.gov), call center operations, and navigator grants. They also have much better access to enrollment data, which can be used to better understand enrollment trends and seek opportunities to better serve the state’s population.