Pennsylvania is firming up plans to run its own health insurance exchange while awaiting a critical U.S. Supreme Court decision.
Pennsylvania would really have a limited role in running the exchange, instead paying the federal government for IT services.
However, state Insurance Commissioner Teresa Miller said the state would handle the call center, outreach, and education responsibilities.
“So if we use healthcare.gov, we’re limiting that risk, and really the expense and heavy burden that goes along with a traditional state-based exchange,” Miller said.
The federal government recently gave preliminary approval to Pennsylvania’s health insurance exchange plan.
“There are a lot of unknowns still. We still don’t know how much the federal government might charge us on an ongoing basis for use of healthcare.gov. Once we know that, I think we’ll have a better sense of whether we might be able to do this for less than the 3.5 percent assessment,” she said.
The current 3.5 percent assessment on health insurers pays for operation of the exchange.
A state-based exchange would be required to keep the status quo if the U.S. Supreme Court decides only states can offer subsidies for health insurance.
An estimated 382,000 Pennsylvanians could lose subsidies for health insurance if an adverse Supreme Court ruling came and the state took no action.
Pennsylvania’s plan would be ready to go for open enrollment in November, Miller said, but she said the state will drop its plan if the court rules in favor of the federal government.
Miller said one person with the state has largely devoted her time to putting together the state’s plan.