HOW HEALTH INSURANCE REFORM WILL BENEFIT PENNSYLVANIA

Skip Navigation

En Español



	HOW HEALTH INSURANCE REFORM WILL BENEFIT PENNSYLVANIA Topics on this page: The New Numbers: Health Insurance Reform Cannot Wait in Pennsylvania Stable and Secure Health Care for Pennsylvania The Health Care Status Quo: Why Pennsylvania Needs Health Reform The New Numbers: Health Insurance Reform Cannot Wait in Pennsylvania Last week, the U.S. Census released its new numbers for the uninsured. The results are sobering and confirm that health insurance reform cannot wait another year. Nationwide, the number of uninsured increased from 39.8 million in 2001 to 46.3 million in 2008. The facts below underscore the urgency of health insurance reform for residents of Pennsylvania. The status quo is not an option. The number of uninsured in Pennsylvania has increased from 1.0 million in 2001 to 1.2 million in 2008. The percent of non-elderly adults without insurance increased from 10.8% to 13.2%. And this number only considers people who are uninsured for an entire year – it does not include people in Pennsylvania who have more recently lost coverage through the recession, or who had shorter gaps in their coverage. Private coverage is eroding under the status quo. The percentage of people with employer-based coverage decreased from 80% of the population in 2001 to 74% in 2008. More workers are being left without protection from health care costs. Too many workers in Pennsylvania do not have health coverage, at 74,000 in 2008. And the proportion of workers from Pennsylvania without insurance has increased, from 9.8% in 2001 to 12.5% in 2008. The problem of the uninsured is a problem that crosses income brackets. The new Census numbers also drive home the fact that everyone in Pennsylvania is vulnerable to losing health insurance. An additional 46,000 people from high-income households are now uninsured. Stable and Secure Health Care for Pennsylvania How Health Insurance Reform will Benefit Pennsylvania LOWER COSTS FOR RESIDENTS OF PENNSYLVANIA Ending the Hidden Tax – Saving You Money: Right now, providers in Pennsylvania lose over $2.4 billion in bad debt which often gets passed along to families in the form of a hidden premium “tax”.¹ Health insurance reform will tackle this financial burden by improving our health care system and covering the uninsured, allowing the 187 hospitals² and the 49,575 physicians³ in Pennsylvania to better care for their patients. Health Insurance Premium Relief: Premiums for residents of Pennsylvania have risen 103% since 2000.⁴ Through health insurance reform, 1,110,400 to 1,309,500 middle class Pennsylvania residents will be eligible for premium credits to ease this burden.⁵ Strengthening Small Businesses: 175,745 employers in Pennsylvania are small businesses.⁶ With tax credits and a health insurance exchange where they can shop for health plans, insurance coverage will become more affordable for them. Reforms that Reduce Your Costs: Under health insurance reform, insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive. Insurance companies will also have to abide by yearly limits on how much they can charge for out-of-pocket expenses, helping 48,600 households in Pennsylvania struggling under the burden of high health care expenses.⁷ INCREASE YOUR CHOICES: PROTECTING WHAT WORKS AND FIXING WHAT'S BROKEN Insurance Stability and Security: Health insurance reform will strengthen our system of employer-based health insurance, with an additional 133,900 people in Pennsylvania potentially getting insurance through their work.⁸ Health insurance reform will also ensure that you will always have guaranteed choices of quality, affordable health insurance if you lose your job, switch jobs, move or get sick. Eliminating Discrimination for Pre-Existing Conditions, Health Status or Gender: 9% of people in Pennsylvania have diabetes⁹, and 28% have high blood pressure¹⁰ – two conditions that insurance companies could use as a reason to deny you health insurance. Health insurance reform will prevent insurance companies from denying coverage based on your health, and it will end discrimination that charges you more if you’re sick or a woman. One-Stop Shopping – Putting Families in Charge: With the new health insurance exchange, you can easily and simply compare insurance prices and health plans and decide which quality affordable option is right for you and your family. These proposals will help the 1,206,100 residents of Pennsylvania who currently do not have health insurance to obtain needed coverage, and it will also help the 648,500 Pennsylvania residents who currently purchase insurance in the individual insurance market.¹¹ Guaranteeing Choices: The largest health insurer in Pennsylvania dominates the market, which limits the choices that you have for finding coverage.¹² With a competitive public insurance option, you will have more choices and increased competition that holds insurance companies accountable. ASSURE QUALITY, AFFORDABLE HEALTH CARE FOR AMERICANS Preventive Care for Better Health: 37% of Pennsylvania residents have not had a colorectal cancer screening, and 21% of women have not had a mammogram in the past 2 years.¹³ By requiring health plans to cover preventive services for everyone, investing in prevention and wellness, and promoting primary care, health insurance reform will work to create a system that prevents illness and disease instead of just treating it when it’s too late and costs more. Improving Care for Children and Seniors: 17% of children in Pennsylvania have not visited a dentist in the past year,¹⁴and 28% of seniors did not receive a flu vaccine¹⁵. Health reform will ensure coverage for kids’ dental, vision, and hearing needs, and will promote quality coverage for America’s seniors, including recommended immunizations. ¹ Hospital uncompensated care cost is estimated using a GAO model and the Hospital Cost Reports. Total uncompensated care is computed as hospital uncompensated care divided by 63% (Hadley and Holahan’s study on “The Cost of Care for the Uninsured” for Kaiser in 2004 found that hospitals account for 63% of total uncompensated care). Data expressed in 2009 dollars using Centers for Medicare and Medicaid Services, “National Health Expenditure Data.” ² 2007 AHA Annual Survey Copyright 2009 by Health Forum LLC, an affiliate of the American Hospital Association, special data request, March 2009. Available at http://www.ahaonlinestore.com. ³ American Medical Association, Physicians Professional Data, year of data 2008, copyright 2008: Special Data Request. ⁴ Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2000, Table II.D.1. Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table X.D. Projected 2009 premiums based on Centers for Medicare and Medicaid Services, “National Health Expenditure Data.” ⁵ U.S. Census Bureau, Current Population Survey. Annual Social and Economic Supplements, March 2007 and 2008. ⁶ Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table II.A.1a. ⁷ Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2006. ⁸ U.S. Census Bureau, Current Population Survey. HIA-4 Health Insurance Coverage Status and Type of Coverage by State--All Persons: 1999 to 2007, 2007. Calculations based on Congressional Budget Office. Letter to the Hon Charles Rangel on America’s Affordable Health Choices Act, July 14, 2009. ⁹ Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2008. ¹⁰ Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007. ¹¹ U.S. Census Bureau, Current Population Survey. Annual Social and Economic Supplements, March 2007 and 2008. ¹² American Medical Association. (2008,2009). "Competition in health insurance: A comprehensive study of U.S. Markets: 2008 Update," American Medical Association. ¹³ Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007. ¹⁴ Child and Adolescent Health Measurement Initiative. 2007 National Survey of Children's Health, Data Resource Center for Child and Adolescent Health. ¹⁵ Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007. The Health Care Status Quo: Why Pennsylvania Needs Health Reform Congress and the President are working to enact health care reform legislation that protects what works about health care and fixes what is broken. Pennsylvanians know that inaction is not an option. Sky-rocketing health care costs are hurting families, forcing businesses to cut or drop health benefits, and straining state budgets. Millions are paying more for less. Families and businesses in Pennsylvania deserve better. PENNSYLVANIANS CAN’T AFFORD THE STATUS QUO Roughly 7.9 million people in Pennsylvania get health insurance on the job¹, where family premiums average $13,646, about the annual earning of a full-time minimum wage job.² Since 2000 alone, average family premiums have increased by 103 percent in Pennsylvania.³ Household budgets are strained by high costs: 19 percent of middle-income Pennsylvania families spend more than 10 percent of their income on health care.⁴ High costs block access to care: 10 percent of people in Pennsylvania report not visiting a doctor due to high costs.⁵ Pennsylvania businesses and families shoulder a hidden health tax of roughly $900 per year on premiums as a direct result of subsidizing the costs of the uninsured.⁶ AFFORDABLE HEALTH COVERAGE IS INCREASINGLY OUT OF REACH IN PENNSYLVANIA 10 percent of people in Pennsylvania are uninsured, and 65 percent of them are in families with at least one full-time worker.⁷ The percent of Pennsylvanians with employer coverage is declining: from 71 to 64 percent between 2000 and 2007.⁸ Much of the decline is among workers in small businesses. While small businesses make up 71 percent of Pennsylvania businesses,⁹ only 51 percent of them offered health coverage benefits in 2006 -- down 7 percent since 2000.¹⁰ Choice of health insurance is limited in Pennsylvania. Highmark and Independence Blue Cross alone constitutes 72 percent of the health insurance market share in Pennsylvania.¹¹ Choice is even more limited for people with pre-existing conditions. In Pennsylvania, premiums can vary based on demographic factors and health status, and coverage can exclude pre-existing conditions or even be denied completely. PENNSYLVANIANS NEED HIGHER QUALITY, GREATER VALUE, AND MORE PREVENTATIVE CARE The overall quality of care in Pennsylvania is rated as “Average.”¹² Preventative measures that could keep Pennsylvanians healthier and out of the hospital are deficient, leading to problems across the age spectrum: 15 percent of children in Pennsylvania are obese.¹³ 21 percent of women over the age of 50 in Pennsylvania have not received a mammogram in the past two years. 37 percent of men over the age of 50 in Pennsylvania have never had a colorectal cancer screening. 72 percent of adults over the age of 65 in Pennsylvania have received a flu vaccine in the past year.¹⁴ The need for reform in Pennsylvania and across the country is clear. Pennsylvania families simply can’t afford the status quo and deserve better. President Obama is committed to working with Congress to pass health reform this year that reduces costs for families, businesses and government; protects people’s choice of doctors, hospitals and health plans; and assures affordable, quality health care for all Americans. ¹ U.S. Census Bureau, Current Population Survey. HIA-4 Health Insurance Coverage Status and Type of Coverage by State--All Persons: 1999 to 2007, 2007. ² Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table X.D. Projected 2009 premiums based on Centers for Medicare and Medicaid Services, "National Health Expenditure Data," available at http://www.cms.hhs.gov/nationalhealthexpenddata/. ³ Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2000, Table II.D.1. Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table X.D. Projected 2009 premiums based on Centers for Medicare and Medicaid Services, "National Health Expenditure Data," available at http://www.cms.hhs.gov/nationalhealthexpenddata/. ⁴ Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, 2006. ⁵ Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007. ⁶ Furnas, B., Harbage, P. (2009). "The Cost Shift from the Uninsured." Center for American Progress. ⁷ U.S. Census Bureau, Current Population Survey. Annual Social and Economic Supplements, March 2007 and 2008. ⁸ U.S. Census Bureau, Current Population Survey. HIA-4 Health Insurance Coverage Status and Type of Coverage by State--All Persons: 1999 to 2007, 2007. ⁹ Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2006, Table II.A.1a. ¹⁰ Center for Financing, Access and Cost Trends, AHRQ, Medical Expenditure Panel Survey - Insurance Component, 2001, 2006, Table II.A.2. ¹¹ Health Care for America Now. (2009). "Premiums Soaring in Consolidated Health Insurance Market." Health Care for America Now. ¹² Agency for Health Care Research and Quality. 2007 State Snapshots. Available http://statesnapshots.ahrq.gov/snaps07/index.jsp. ¹³ Child and Adolescent Health Measurement Initiative. 2007 National Survey of Children's Health, Data Resource Center for Child and Adolescent Health. ¹⁴ Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2007.