Smart Talk

Smart Talk is a daily, live, interactive program featuring conversations with newsmakers and experts in a variety of fields and exploring a wide range of issues and ideas, including the economy, politics, health care, education, culture, and the environment.  Smart Talk airs live every week day at 9 a.m. on WITF’s 89.5 and 93.3.

Listen to Smart Talk live online from 9-10 a.m. weekdays and at 7 p.m. (Repeat of 9 a.m. program)

Host: Scott LaMar

Smart Talk: Questions about health insurance as open enrollment begins

Written by Scott LaMar, Smart Talk Host/Executive Producer | Nov 10, 2016 4:12 AM
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What to look for on Smart Talk Thursday, November 10, 2016:

While the politics of the Affordable Care Act or Obamacare were still being debated, open enrollment for health insurance on the healthcare exchange began last week and runs until January 31, 2017.

Almost 90% of Americans now have health insurance but there are still hundreds of thousands of people who are uninsured and could qualify.

Every open enrollment period has a few changes and this year is no exception.  Rates for the most part will be higher and there are fewer insurance companies participating or offering insurance plans.

However, there are tax credits available to offset some of the rate hikes. 

For those who don't have insurance, a fine of $695 and $347.50 for each child will be leveled.

Thursday's Smart Talk answers your health insurance questions.

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Tia Whitaker, Statewide Director of Outreach & Enrollment with the Pennsylvania Association of Community Health Centers / Lynn Keltz, Executive Director of the Pennsylvania Mental Health Consumer's Association

Appearing on the program are Lynn Keltz, Executive Director of the Pennsylvania Mental Health Consumer's Association and Tia Whitaker, Statewide Director of Outreach & Enrollment with the Pennsylvania Association of Community Health Centers.


Pennsylvania Association of Community Health Centers - (866)944-CARE (2273)

Pennsylvania Mental Health Consumer's Association - (855)274-5626


        I am a 62 year old, healthy female, employed, no employer-sponsored health care plan.  Husband is retired and is on Medicare & a supplemental plan through Capital Blue Cross.  Last year when he retired, I had the task of acquiring health insurance for myself.  After much research, I went with a CBC Value HMO product with a premium of $605.00/month, $4,500 deductible.  A bit of a hardship but have been able to do - cannot take the stress of not having any insurance.

        With the changes in the ACA and the market, I was informed by CBC that they will  not offer my current plan in 2017.  CBC has gone from 15/20 plan options down to 4.   A comparable plan premium for me in 2017 would be $1117 a month!  

         First part of my question to Commissioner Miller - why did the Insurance Department approve rate hikes HIGHER than what the insurer requested?

         Yes, the subsidies have increased for 2017, however for a household of 2 (even if only 1 is asking for insurance), the subsidy is capped at $64,000.  Keep in mind this is annual gross income.   Now, my husband and I make closer to $70/year - GROSS income - not a lot of money in my mind.   A premium of $900 to $1,117 a month is close to 20% of our annual income -- how ridiculous is this for a 62 year old healthy individual?

         When I read statements like -- you can get insurance for $300/400 a month -- I see red --  yes, you can if you are under 55 years of age and the cost for a young person 30 and under is less than this even without a subsidy!  

          Recently read that 75% of Pennsylvanians qualified for a subsidy -- that leaves 25% of us out there that do not.   I can't be the only older healthy adult that is in this situation.

         Second question - why isn't there an option, a plan out there for healthy people that need a few year bridge to Medicare that is affordable?  Put medical criteria on it to lower the risk.  Why can't it be non-approved ACA plan and let the individual decide -- willing to pay the penalty for a non-approved plan than go without insurance.

         Last year, from September to December 2015 - I chose to go with the short-term coverage option.  An excellent option for a healthy individual.  I was contemplating doing this again for at least 2017 -- taking the risk of not getting any new illnesses (does not cover pre-existing conditions) and also willing to pay the penalty.  Even with the penalty, looking at paying $4,000/year versus $13,000/year for some kind of health insurance was better.   HOWEVER, the federal regulations are changing for short-term coverage in 2017.  One will only be allowed to sign up for 3 months and after that 3 month period, if it is not open enrollment time, you have no option!

         Why are the insurers and our government (both federal and state) shutting the door on consumers?   

           I am now looking at an Aetna plan -- which is $771/a month (now, with a $6,000 deductible and still $166 more a month than what I am paying now).  Yes it will be tough but doable.  And, it will seriously impede our ability to continue to save for "my" retirement which is not that far away but at least I will have some peace of mind in case anything happens.              - anon

Consider this. 

  • D Trump is a business man.
  • One of the biggest expenses to a company is Health Care
  • Watch D Trump push for a Single Payer Govt Funded system.
  • Watch company expenses go DOWN and profits go UP.         -stew


1 question...1 comment:

  1. As an insurance agent, I have clients who are calling who do not qualify for the Marketplace and tax subsidies due to a higher income. Yet their premium has increased up to 60% in some cases. Are there any "affordable" options for those off the Marketplace? My own plan increased from $1,010 to $1,635 per month or my wife & I.
  2. A huge tax burden concern--as discussed we have clients whose income is not changing for 2017 but the cost of their plans have increased the same 60%...their net is the same. This system is going to self-implode and not be able to fund the PPACA mandates.

            All of our carriers have decided to not pay commissions on new business so I am out of the individual health insurance business of helping our insureds!

         I don't want socialized medicine but how about expanding Medicare for all Americans (for a cost obviously) and allow us to select a 'supplemental plan' just like seniors on Medicare.     - Mike L.


My husband and I make a bit above the limit to get any subsidies for my health insurance.  My husband is on Medicare and I do not work.

My insurance has increased tremendously since 2013.

2013 - $299/mo. plus $1800 deductible
2014 - $329/mo. plus $2600 deductible

2015 - $457/mo. plus $2100 deductible

2016 - $615/mo. plus $6300 deductible

2017 - $1220/mo. plus $4500 deductible

How can we keep paying these outrageous fees?

- Deb, Adams County

Can you tell me what the income guidelines are fora family of four to get a tax credit and what the income guidelines are versus getting regular insurance versus medical assistance.     - Jarrah 




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