Pennsylvania health insurance marketplace: history and
news of the state’s exchange

BCBS of Pennsylvania and Bright Health offering plans for 2018; cost of CSR added to silver premiums,making other
metal levels particularly affordable

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Louise Norris
Individual health insurance and health reform authority; broker
March 22, 2018

More Pennsylvania coverage

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    Insurance Guide
    • A guide to health insurance in
      your state.
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    • Your state’s Medicaid expansion,
      eligibilty, contacts
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    • Insurance for those over 64

Highlights and updates

  • 2018 enrollment down 4.6% from 2017
  • One insurer in 2017, but Bright Health joined in 2018
  • Average rate increase 15.6%, including added premiums to cover CSR cost
  • Cost of CSR added to silver exchange, other metal levels particularly cheap for some
  • 2018 rates and new insurer indicate death spiral no longer a danger

Pennsylvania exchange overview

Pennsylvania has a whopping eight insurers that participate in the 2019 open exchange. The average rate increase was estimated 4.9% but later turned out to be just .7%. The average approved premium ended up decreasing by 2.3%. For 2018, over 389,000 residents enrolled in a private health care plan.

Medicaid in Pennsylvania

Pennsylvania chose to expand Medicaid. In the first 2 days in enrollment, 41,500 residents applied for coverage. By 2018, 694,047 residents had enrolled in Medicaid thanks to the expansion. Additionally, the state has zero regulations on short term health insurance plans so Pennsylvania can offer short term plans with initial terms up to 364 days and the option to renew for a total of 36 months. By 2017, the uninsured rate had dropped to just 5.5% while the national uninsured rate was 8.7%.


Medicare in Pennsylvania

By 2018, Medicare enrollment reached 2.7 million which was almost 21% of the state’s population. In Pennsylvania, 84% of beneficiaries qualify on age alone and 16% qualify due to a disability. As of 2016, Medicare spends $9,714 per enrollee per year. 42% of enrollees chose to opt for a Medicare Advantage plan for additional benefits and 36% opted to partake in a Medicare Part D plan that covers prescription drugs.


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.