– Pennsylvania will be running its own health insurance exchange, once the Affordable Care Act allows for the creation of the exchanges in 2014.
The exchange will be open to individual purchasers of all income levels, including those on Medicaid, and small-group purchasers such as small businesses. Other key points of the health care reform law related to the health exchanges:
- Private health insurers participating in exchanges must offer a set of "essential health benefits" in 10 categories, including hospitalization, ambulatory care, maternity care, prescription drugs and laboratory services.
- Benefits should be comparable to those offered under "a typical employer plan." However still undecided are what benefits are "essential" and what employer plans are "typical." The Obama administration recently announced that those decisions will be left to the states.