The Affordable Care Act (ACA), activated under the Obama Administration in 2010, was hailed as a major breakthrough in healthcare reform. Eight years later, however, the ACA experienced confusion in the marketplace and increasing problems with affordability largely due to the Trump administration’s efforts to weaken and eventually destroy the program. Pennsylvania enrollments in the federal exchange (healthcare.gov) declined from 426,059 in 2017 to 365,868 in 2019. People hit hardest by higher costs were those not eligible for subsidies.
Pennsylvania was among a handful of states that began developing their own exchanges partly in response to the sabotage efforts at the federal level, but also to take advantage of new information technologies to help reduce operating costs through their efficiencies. In addition, state-run exchanges can target local needs better and create solutions based on their own demographics. Pennie, Pennsylvania’s recently launched state exchange, benefits from the best practices gained from other states’ experiences. The leaders in this effort projected a 5-10 percent savings in health insurance costs in the first few years of the new marketplace.