Pennsylvania launches its own health insurance marketplace

Pennsylvania on Tuesday debuted its state-based insurance marketplace, Pennie.com, which will give residents who buy individual health plans an extra four weeks to shop for 2021 coverage.

Open enrollment through Pennie will run Nov. 1 through Jan. 15.

With Pennie’s launch, Pennsylvania joins 14 states that run their own health insurance marketplaces, rather than relying on the federal marketplace, healthcare.gov, a move Pennsylvania Insurance Commissioner Jessica Altman described as “a landmark moment in health care and access to health care for Pennsylvania.”

The Affordable Care Act required states to either participate in the federal marketplace or create their own. Pennsylvania’s General Assembly in 2019 passed a law to transition from healthcare.gov to a state-based exchange. New Jersey launched its own marketplace, getcoverednj.gov, for the 2020 enrollment season.

The switch gives Pennsylvania more control over a key creation of the ACA — the online insurance marketplace — at a time when the entire health law is in legal jeopardy. The Supreme Court is scheduled to hear arguments in a Texas lawsuit to invalidate the ACA. The Trump administration is supporting the lawsuit.

“Despite being in one of the largest health care crises our country has seen, President Trump and many of his Republican allies are fighting to end the Affordable Care Act and rip away health care from millions of Pennsylvanians," Altman said Tuesday during a call with reporters and stakeholders. “We all have to be incredibly vigilant and vocal about the negative implications that would have.”

About 5% of Pennsylvania residents are covered by individual health plans, which will now be sold through Pennie. Many more benefit from other ACA insurance rules, such as Medicaid expansion, protections for people with preexisting conditions, and coverage for adults up to age 26 on a parent’s insurance plan.

» READ MORE: Federal court ruling on ACA could imperil preexisting condition coverage.

“The Affordable Care Act today is still here," Altman said. "We have to keep moving our health care system forward and making it better for the people who rely on it, and this initiative is Pennsylvania doing exactly that.”

By establishing its own insurance marketplace, Pennsylvania will be able to increase the number of assisters available to help people enroll in coverage from 80 to 100 across the state, expand its marketing campaign, and establish a reinsurance fund that will help control rising premium rates by covering costs for the most expensive patients.

For people who have used healthcare.gov in the past, the online shopping experience should be similar: The website will allow people to compare plans, evaluate out-of-pocket costs, and determine whether they are eligible for a tax credit.

Tax credits are available to offset the cost of insurance premiums based on income and family size. An individual earning less than $50,000 a year or a family of four earning less than $105,000 a year, for instance, will likely qualify. Users whose income qualifies them for Medicaid or the Children’s Health Insurance Program (CHIP) will be redirected from Pennie to the Department of Human Services for enrollment.

“We strive to support all Pennsylvanians looking for coverage and recognize many who lost their employer coverage due to COVID-19 may be new to the marketplace,” said Zachary W. Sherman, Pennie’s executive director, who previously served as the director of Rhode Island’s ACA marketplace.

» READ MORE: It’s health insurance enrollment season, but you can sign up for Medicaid all year

One shortcoming of the new website: Unlike healthcare.gov, Pennie.com will not be fully translated into Spanish. Some aspects of the website, such as videos and forms, will be available in Spanish, as will marketing materials, in-person assister support, and telephone support. Pennie is considering a fully translated website for future enrollment seasons.

Pennie and the Pennsylvania Insurance Department are planning an expansive digital and print marketing campaign to let people know about the new website. But anyone who misses the message and turns to healthcare.gov will be redirected to Pennie.com. User accounts created through healthcare.gov during previous enrollment periods will be transferred to Pennie.com.

» READ MORE: 10 tips for avoiding health insurance scams