Pennsylvania Health Insurance

Last Updated on September 21, 2020 by Andrew Lee

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Health care in Pennsylvania has seen both good and bad changes over the years, and all these have a considerable impact on health insurance. There are many updates in this area you should know of. These include the significant reduction in uninsured rating, its standing in health ratings, the statewide average rate increase, and most importantly, what you can expect your premiums to look like this year. This guide will help you have a better understanding of health insurance in the state, as it covers all of these above-mentioned changes.

Above-average health ratings

Places that have laudable health ratings usually enjoy good insurance rates. If PA manages to do better in this criteria in the future, it can increase its chances of providing its citizens with easier-to-afford premiums. In the 2015 Commonwealth Fund’s Scorecard on State Health System Performance, it ranked 20th of 51. Its best scores (quintile of 1) were for Access as well as Prevention & Treatment. It scored a 2 for Equity, and a 3 for both Avoidable Hospital Use & Costs and Healthy Lives. Some notable findings from the state’s “Healthy Lives” scorecard include the following:

  • Mortality amenable to healthcare: 82 out of 100,000 people
  • Breast cancer fatalities: 21.8 out of 100,000 women
  • Colorectal cancer fatalities: 15.9 out of 100,000 people
  • Percentage of adult smokers: 19%
  • Adult obesity: 31%
  • Obesity in children aged 10-17: 26%

Its performance under “Access” bests that of the country, in general, as you can see from the following statistical comparisons:

  • 12% of adults (19 to 64 years old) don’t have insurance, compared with the national average of 15%
  • 5% of children (infants to 18 years old) are uninsured, as opposed to the countrywide average of 6%
  • 12% of the adult population chose not to obtain insurance due to the high costs associated with it, in comparison with the 16% average in the U. S.
  • 12% of adults had expensive out-of-pocket medical bills, 4% fewer than the 16% national average

More people now have coverage

Over the years, the Keystone State managed to pull down is uninsured rating. This has helped in somehow preventing rate hikes to reach levels a lot of people can no longer afford. According to a U.S. Department of Health & Human Services report, back in 2010, it had a 10.2% uninsured rating. Within five years, this went down to just 6.4%. Simply put, the state, with an estimated population of 12,802,503 (2015, latest data), saw a 3.8% decrease in the number of residents without insurance. This means that 479,000 individuals gained access to

Premium averages this 2017

Pennsylvania’s health insurance rate increases for both exchange and non-exchange types of plans average at 32.5% this year. And while this is 7.5% higher than the U.S. average of 25%, it is much lower than those of other states. Some have to deal with hikes going beyond 40%. Note too, that the range is from having no increase to 0.93% (lowest) to 50.1% (highest). The United States Department of Health & Human Services kindly provided these premium average projections for 2017, which you can use to gauge your own premiums:

  • Average lowest-cost, monthly premium within metal level: $478
  • The average net premium for the lowest-cost plan within the metal tier: $167
  • Second-lowest silver before advance premium tax credit (for a 27-year old with a $25,000 household income): $327
  • Second-lowest silver after advance premium tax credit (for a 27-year old with a $25,000 household income): $142
  • Second-lowest silver before advance premium tax credit (for a family of four with a $60,000 household income): $1,185
  • Second-lowest silver after advance premium tax credit (for a 27-year old with a $25,000 household income): $405

Making coverage easier to access will help improve lives

Health insurance no doubt makes the lives of people better, since this is their ticket to lower out-of-pocket expenses when paying for medical and hospital services. If the PA authorities make coverage easier for its residents to access, it will rank even higher in health performance studies, which will pave the way for better premiums, and more importantly, higher quality of life.