Wolf and Cutler

Pennsylvania House Majority Leader Bryan Cutler, left, looks on as Gov. Tom Wolf signs House Bill 3 into law Tuesday, July 2, 2019. Also at the table was Jessica Altman, the state insurance commissioner.

THE ISSUE

On Tuesday, Gov. Tom Wolf signed into law House Bill 3, which creates an online state health insurance exchange and new reinsurance plan. The state-based marketplace, which officials hope will be operational by Jan. 1, 2021, will take the place of the federal exchange established in 2010 under the Affordable Care Act. Officials say it will reduce user fees, lower premiums, help to contain the state's Medicaid costs, and expand access to health care.

Last week, video of a screaming match in the Pennsylvania Senate went viral nationally, boosting only the commonwealth’s reputation for dysfunction.

Tuesday’s bill signing in the state Capitol was, by contrast, bipartisan and upbeat. Democratic Gov. Wolf signed HB 3 into law as Republican House Majority Leader Bryan Cutler, of Peach Bottom, sat next to him, looking on in approval. It was an image we’d like to frame to remind ourselves, when things get rough, of what is possible when elected officials work across party lines for the good of the people who put them in office.

HB 3 was co-sponsored by Cutler and House Democratic Leader Frank Dermody, of Allegheny County. In an op-ed published June 14 in LNP, Cutler and Dermody wrote that relying on the federal exchange made sense at first — the logistics of launching a state exchange were expensive and complex.

But now, more than a dozen states operate their own exchanges, and Pennsylvania is joining the do-it-yourself party. This will cost “less than half what we pay the feds to handle the job,” Cutler and Dermody wrote.

Here’s how it will work, according to the governor’s website:

This year, the federal government is projected to collect, via a user fee on premiums, $98 million from Pennsylvania insurers.

A slightly reduced fee next year will bring in $88 million.

As it launches its own exchange, the commonwealth will begin collecting the user fee incrementally in 2020 and then in full in 2021, so the money will be in Pennsylvania’s coffers rather than federal ones.

Using a federal waiver, “the state will create a reinsurance fund that will directly pay some of the health care costs for high-cost individuals.”

This, the governor’s website says, “will lower premiums for other insured Pennsylvanians on the individual market as well as reduce the approximately $2 billion cost for health care premium subsidies to assist low-income individuals.”

The savings will “be used to create this reinsurance fund.” And the “combined savings and anticipated federal government reinsurance contribution will save Pennsylvanian consumers up to $250 million in annual health insurance premiums.”

As The Associated Press reported Tuesday, the Wolf administration says the state-based exchange “can lower premiums by 5% to 10% for the 400,000 people who buy policies in the marketplace.”

The savings should help, in particular, the roughly 80,000 people who currently buy policies through the federal exchange, but don’t qualify for a federal tax subsidy.

All this is expected to be accomplished without a dime from the state’s general fund — that is, taxpayer money.

This is a win for everyone.

And it was secured by leaders who set their sights on something bigger than a narrow partisan victory.

As Cutler and Dermody noted in their op-ed, “This isn’t a Republican or Democratic issue, it’s a people issue. It’s not red vs. blue, it’s all green. It’s a great example of how we can and should work together to make sure everyone can afford to see a doctor when they get sick, and our job-creating health care industry has customers who can pay their bills.”

This is absolutely right.

We wish this bipartisanship could have been extended to the legislation that would help counties, including our own, pay for new voting machines. That should have been a clean bill — to paraphrase Cutler and Dermody, election security isn’t a Republican or Democratic issue, it’s a democracy issue. Alas, a provision to eliminate straight-ticket voting was added to the legislation without any substantive discussion. We’re not fans of slapdash legislating.

We also wish that those involved in last week’s Senate fracas would reflect on their own behavior, instead of continuing to castigate their political opponents. That mess left no one covered in glory.

Instead, let’s focus on what happened Tuesday. Let it serve as a reminder that government works when those in it work together for the common good.


Addendum Sept. 4, 2019