State health insurance program seeks new customers again

Borys Krawczeniuk, The Citizens' Voice, Wilkes-Barre, Pa.
·3 min read

Feb. 23—Unemployed residents have another chance to buy affordable health insurance through a state program.

Pennie, the state's health insurance marketplace for the uninsured, opened a new enrollment period last week that will last until May 15.

The state General Assembly and Gov. Tom Wolf adopted Pennie in 2019, after the state relied for years on the federal government's insurance marketplace, healthcare.gov, which grew out of the 2010 Patient Protection and Affordable Care Act, better known as Obamacare.

More than 338,000 enrolled during Pennie's first enrollment period that began Nov. 1 and ended Jan. 15. In local counties, 6,093 Lackawanna residents enrolled; Luzerne, 8,050; Monroe, 5,232; Pike, 2,063; Susquehanna, 1,306; Wayne, 1,878; and Wyoming, 891.

Normally, Pennie allows one open enrollment period a year, though someone who loses employer health insurance during a year can apply within 60 days after that. The COVID-19 pandemic created a special circumstance that prompted Pennie's board of directors to open a second enrollment period, said Zachary Sherman, Pennie's executive director.

Pennie is not government-run health care. The agency oversees a marketplace where seven insurers offer health insurance plans for a set price each month. Not every insurer offers a plan in each part of the state, but three do in Northeast Pennsylvania — Geisinger, Highmark and UPMC.

Pennie offers qualified residents federal help for paying premiums and, sometimes, copayments and deductibles, depending on income.

"It's a good competitive marketplace and we've seen at least two insurers in the last couple of years come into the market and expand their reach across the commonwealth," Sherman said. "And that financial assistance is pretty significant. Nearly nine out of 10 of our customers get it (money to help pay the premiums) and the average savings for those who receive the premium tax credits is about $515 per month."

The costs and financial aid depend on the size of a family. An uninsured single person earning up to $51,000 a year and a family of four with household income of up to $105,000 annually could qualify, Sherman said.

The program is intended for people who don't have access to affordable health insurance, he said, but generally not for people who have insurance through their employers. The federal subsidies and premiums cover the costs and no state tax money is involved, Sherman said.

Antoinette Kraus, a Pennie board member and executive director of the Pennsylvania Health Access Network, which advocates for help for the uninsured, said the second enrollment period was worth offering considering people's COVID-19 fears.

"There's a lot of folks that are now uninsured that maybe missed the opportunity to sign up during the open enrollment period," Kraus said. "And also people are scared right now about not having health coverage in a way they might not have been before because they're worried about getting sick or needing treatment for COVID. So it's another opportunity to kind of address those fears and allow people to sign up. And I think we want to emphasize that financial assistance is available. So folks should really check it out to see what they might be eligible for."

Contact the writer:

bkrawczeniuk@timesshamrock.com; 570-348-9147;

@BorysBlogTT