00:00 - The Capital Blue Cross Forum is sponsored in part by Capital Blue Cross.

00:06 - Good morning.

00:07 - I'm Doug Furness, and welcome

00:08 - to this episode of the Public Affairs Forum, sponsored by capital BlueCross.

00:12 - Capital BlueCross is a regional Blue Cross plan serving approximately

00:16 - 800,000 members in central Pennsylvania and the Lehigh Valley.

00:21 - I want to thank PCN, our long time partner in these broadcasts,

00:24 - for their commitment to the program

00:26 - and to the relationship it has with Capital Blue Cross.

00:29 - We look forward to continuing that relationship for many years to come.

00:33 - Our format today is familiar to many of you.

00:36 - Our guests will make a brief presentation followed by a question and answer period

00:40 - moderated by me.

00:41 - A member of our live audience wants to ask a question of our guest.

00:45 - Please submit it through the Q&A function and I'll ask.

00:49 - Our whole program should last about an hour.

00:51 - I'm excited about our program today.

00:54 - Our guest today is Devon Trolly, the executive

00:57 - director of Pennsylvania's Health Insurance Exchange.

01:01 - Penny Devon Trolley is served as the executive director of Penny

01:06 - since March of 2023.

01:08 - She joined the agency following a successful tenure as the director of Get

01:13 - Covered New Jersey, new Jersey state based ACA, the Affordable Care Act

01:17 - marketplace where she led its launch

01:21 - and expansion beginning in 2020.

01:24 - With deep expertise in the health care,

01:26 - with health care policy and operations.

01:29 - Devon Trolley brings broad experience from her work at the Centers

01:33 - Medicare and Medicaid Services,

01:36 - where she helped stabilize healthcare.gov

01:39 - and advised on maternal health and the opioid crisis.

01:45 - And from her time as a senior advisor in the United States Senate

01:49 - during the passage of the Affordable Care Act in 2010.

01:52 - She's also a proud graduate of the Pennsylvania State University,

01:56 - holding both a bachelor's in health policy and administration

02:00 - and a master's in health administration.

02:03 - Under her leadership.

02:05 - Penny has, Penny enrollment has grown to record levels

02:08 - supporting more than 370,000 Pennsylvanians

02:12 - and driving a 17% increase during her first open enrollment period.

02:17 - Please welcome Devon Trout.

02:21 - Good morning.

02:22 - Morning, Doug.

02:23 - Thank you so much for having me on today.

02:27 - I thought I would start off by just telling,

02:30 - sharing a little bit of information about what Penny is

02:33 - and then really looking forward

02:34 - to having more conversation and getting in a little bit deeper.

02:37 - But just to level set, I wanted to talk about

02:40 - what Penny is and who it serves here in Pennsylvania.

02:43 - So Penny is Pennsylvania's health insurance marketplace,

02:47 - and what that means is that we're a place to come

02:50 - if you don't get coverage through another source.

02:52 - So if you don't get coverage through your employer,

02:56 - if you don't qualify for Medicaid, or if you're not old enough

02:59 - to qualify for Medicare, Penny could be a great option to look at.

03:03 - And many of our enrollees 500,000 Pennsylvanians

03:07 - are currently enrolled through Penny fall into those categories.

03:11 - They are independent business owners or contractors.

03:14 - They're farmers or people with part

03:17 - time jobs, or many are also gig workers.

03:21 - So we have a lot of different people across Pennsylvania who, again,

03:24 - don't get coverage from another source and have found high quality, affordable

03:28 - coverage through Penny.

03:31 - Patty has really two important parts to be aware of.

03:34 - One is that we are the only place to get premium tax credits

03:38 - to lower the cost of coverage coverage, if you buy it on your own

03:42 - from a private health insurance company, could be 5 or $600 a month.

03:47 - But through Penny, what you pay for health coverage is based on your income.

03:51 - So some people, with lower incomes,

03:54 - pay $10 a month for those same health insurance plans.

03:58 - Others pay 100 or $300.

04:01 - It really depends on income.

04:03 - But Penny is the only place

04:05 - to get those tax credits that lower the cost of coverage.

04:09 - Another really important part about Penny

04:11 - is that all the health plans through Penny,

04:14 - and they're available from your well known insurance companies across Pennsylvania.

04:18 - It's important to note Penny is not an insurance company.

04:21 - We just provide apples to apples.

04:23 - Comparisons of health plans from many insurance companies

04:27 - across the Commonwealth.

04:28 - And the one thing that all of these health plans have in common

04:32 - is that they have the most consumer protections that you can possibly have.

04:36 - This means that what you pay in a year or over your lifetime,

04:40 - there's no limit on that. There used to be limits,

04:42 - but in plans through Penny, there are no limits on that.

04:45 - And there are many other protections.

04:48 - All plans have to cover essential health benefits,

04:51 - have to cover care for preexisting conditions

04:54 - and many other consumer protections that make sure that the plan you get

04:58 - when you purchase it through penny is a high quality plan

05:01 - that will be there for you if you get sick or injured,

05:05 - or have any other type of medical need that comes that comes up.

05:09 - So those are really the two important parts about Penny.

05:13 - Again, it's where you can get financial savings

05:15 - through premium tax credits that lower what you pay per month.

05:18 - Nine and ten penny enrollees get those tax credits

05:22 - and do see much lower costs.

05:25 - On average, penny enrollees save $6,000 a year on those health

05:30 - insurance premiums, and that's why it makes it more affordable.

05:34 - So happy to take your questions and looking forward

05:37 - to talking more about Penny, but wanted to talk at a high level

05:39 - about what Penny is and who it serves, and how.

05:43 - We already have 500,000 Pennsylvanians enrolled through Penny today.

05:47 - Outstanding. Thank you.

05:49 - Thank you for that.

05:50 - That that brief synopsis of what is Penny?

05:54 - I am curious right at first question is

05:58 - what is the virtue of a state exchange?

06:00 - We all know about healthcare.gov.

06:03 - And when it started, many of us, remember,

06:07 - the fits and starts of the, the

06:10 - of the federal exchange, healthcare.gov.

06:14 - Pennsylvania went its own way, creating its own own exchange several years ago.

06:19 - My question to you is what is The verge?

06:20 - Explain to the audience what the virtue of Pennsylvania

06:23 - running its own exchange is for the fluorescent es of Kamala?

06:28 - The great question, having

06:30 - been at healthcare.gov at the start, I remember the rocky start very well.

06:34 - But also it gives me a great perspective of how much value

06:38 - can be brought at the state level.

06:40 - So healthcare.gov is really sort of a one size fits all across

06:44 - all the different states.

06:45 - About 30 currently.

06:47 - And there are so many benefits for having the health insurance

06:50 - marketplace be based here in Pennsylvania, operated by Pennsylvanians.

06:55 - For those who maybe weren't,

06:58 - following all the state Assembly pieces really closely.

07:00 - Pennsylvania created Penny in 2019 through a bipartisan unanimous vote

07:06 - because it was clear that having more state level control over,

07:11 - the health insurance marketplace and the market generally

07:14 - would allow Pennsylvania to better serve people who need coverage.

07:18 - So I'll give a couple of examples of that.

07:20 - The value that can be brought.

07:22 - One is that we just know Pennsylvania better

07:24 - so we can see different areas where maybe there's higher

07:28 - uninsured rates, where we know more people are not getting coverage,

07:32 - or we know it can work with community organizations.

07:37 - In areas where we know there's a lot of people looking for coverage,

07:40 - we can have stronger relationships with those community organizations.

07:44 - With Pennsylvania's health insurance agents and brokers.

07:47 - And really just kind of look across at what people are

07:50 - looking for, what they need, how to simplify processes.

07:53 - And we can do that.

07:55 - Two quick examples.

07:56 - So we work really closely with Medicaid because based on income,

08:00 - some people qualify for Medicaid.

08:01 - And if they make too much they can come and qualify for Penny.

08:04 - So we have a lot of people whose income changes

08:06 - and they switch between these two programs.

08:09 - As a state based insurance marketplace, we were able to cut the steps in half.

08:13 - If you have to go from one program to another.

08:16 - So that saves anyone looking for coverage a lot of time and effort

08:20 - to just kind of have more of a seamless transition between those two types

08:23 - of coverage to make sure that people can stay covered.

08:26 - And another example is that we saw that in some counties,

08:31 - people were not enrolling

08:32 - as much, and they seem to be falling behind the rest of the state.

08:36 - For example, in a couple of years ago, that was Philadelphia County.

08:39 - So we put more effort into increasing outreach there

08:42 - and to building relationships with local community organizations.

08:45 - And we were able to,

08:47 - reach more people and see more enrollment because of those efforts.

08:51 - And so we expanded those to other counties taking that model that worked

08:55 - so that we can make sure that people know that Penny is an option, know how to get

08:59 - enrolled and have the help they need on the ground in their communities

09:02 - to go through the enrollment process.

09:07 - That's an interesting point.

09:08 - I just a question that came to me is if somebody is watching,

09:14 - this program at

09:15 - some, at a later date somewhere, across the state,

09:19 - and they are part of a community group

09:22 - and they are interested in

09:26 - boosting

09:28 - health insurance participation in their area.

09:31 - How would they go about contacting you to say, hey,

09:35 - I think we have a, a situation in our, in our part of the world

09:39 - where we could use some assistance to try to boost,

09:43 - you know, health insurance, take up numbers.

09:46 - How would they go about doing how would somebody go about doing that?

09:50 - Yeah, actually, it's such a timely question as well,

09:52 - because we are, again, it is a benefit of being a state based marketplace.

09:56 - We looked at where our local health was, and we thought

10:00 - we can bring more local help across more parts of Pennsylvania.

10:03 - So we are currently looking at expanding our partners on the ground and expanding

10:07 - that network of people who can help either get information out through pamphlets,

10:12 - or even if they are seeing a lot of people who they know are looking for coverage

10:15 - and want to find a way to connect them or help them more,

10:18 - we're looking to, to to work more with those organizations across as well.

10:23 - So on the website

10:25 - penny.com, that's an icon.

10:29 - If you are looking for help, there's a button that says get help.

10:32 - And then you can search based on your area where you have insurance brokers and,

10:37 - enrollment assistance that local community organizations that can help

10:41 - you apply for coverage and enroll in coverage.

10:45 - And if you're an organization, you can also, on our website,

10:48 - find out how to get involved more directly with Penny to help,

10:52 - serve your community in that way as well.

10:55 - Great.

10:56 - Now let's get into the nuts and bolts.

10:58 - So because people are going to, to a lot of people, this is something.

11:03 - No, it is an organized action in spite of everybody's best efforts.

11:08 - That, that a lot of people just don't know a lot about.

11:11 - So let's try to, open the hood, so to speak, and see what makes this,

11:16 - what makes penny tech

11:19 - explain to the audience how the exchange works.

11:21 - How where is it funded?

11:23 - What's the Commonwealth's contribution?

11:25 - All of those nuts and bolts.

11:26 - Where are their tax dollars?

11:29 - Where might their tax dollars be present in this organization?

11:34 - Sure. Yeah.

11:34 - So, Penny operates really to connect

11:38 - health insurance companies and health plans.

11:41 - Again, those high quality health plans with people looking for coverage.

11:44 - And the part that we really bring in is the tax credit and making

11:49 - sure people can get that tax credit to lower the cost of that coverage.

11:53 - So we are we are independent state agency.

11:56 - We sort of operate,

11:58 - a little bit differently than other state agencies

12:01 - because we are independent and we are funded not through state dollars,

12:05 - but through funds that come from the insurance companies that sell plans

12:10 - that are offered on Penny, that people can get a tax credit to then enroll in.

12:15 - So we are completely funded by that.

12:17 - So, you know, as enrollment goes up, our funding goes up.

12:21 - And that allows us to meet the needs of higher numbers of enrollees.

12:25 - And that is how we are funded.

12:27 - So there are no state tax dollars,

12:30 - at play.

12:32 - For our, our operations, there is federal funding for that tax credit.

12:37 - It doesn't come directly to us for, for most of our operations,

12:41 - but it does have a really big role in the tax credit that people

12:46 - receive through Penny, because it is a federal premium tax credit.

12:49 - So it's a tax credit that you tell the IRS that you received

12:53 - and they, you know, make sure you got the right amount.

12:57 - So that is the federal part.

12:59 - And it's actually

13:00 - a really significant part because those tax credits are, you know,

13:05 - as I said, $6,000 a year on average for penny enrollees.

13:09 - And that and so we are subject to, you know, changes

13:13 - in federal policy changes and federal rules.

13:16 - And so that part

13:17 - really is very dependent on, you know, all the different

13:21 - federal pieces that that come into play in the federal budget.

13:25 - We're going to get to the tax credits in a, in a, in a second.

13:28 - And that is very important.

13:30 - But for somebody watching and they're sitting in their

13:33 - in their living room saying, you know I need to get insurance.

13:36 - How do I go about it?

13:38 - How do how do I how do I

13:42 - choose whichever plan might be right for me?

13:45 - How does that whole process work?

13:48 - What if walk us through it if you can.

13:50 - If Doug Furnace is trying to apply for insurance, how would that

13:54 - how would that work?

13:55 - What would it look like?

13:57 - And what could, the viewers expect when they, start down that path?

14:02 - Yeah, sure.

14:03 - So the first thing you would do is go to penny.com again.

14:06 - That's p and I e.com.

14:10 - And you can do the whole process online.

14:12 - You don't have to if you want additional help.

14:14 - If you want in-person help or help over the phone

14:17 - that is widely available as well.

14:19 - But it is possible to do the whole process online.

14:22 - So that's a good place to start, because if you want extra help,

14:25 - there's a big button there that says get help.

14:27 - So that's where you can start if you don't want to do it online.

14:29 - But if you do, here's what it would look like.

14:32 - You go to penny.com.

14:33 - You'll see a button that says get a financial estimate or a savings estimate.

14:38 - You click on that and then you just have to put in

14:41 - about five pieces of information.

14:43 - It's your zip code.

14:45 - How many people are in your family, their birthdates

14:48 - and how much generally how much income your household has.

14:52 - From that, you'll be able to just instantly

14:54 - get a general sense of how much tax credit you'll be eligible for.

14:59 - And I also want to know, because sometimes we get this question.

15:01 - We don't do anything with that information that we you know,

15:04 - I know sometimes people,

15:06 - go on websites,

15:06 - you know, to put a bunch of information in and before you know it,

15:08 - you're getting all these these phone calls or other people seem to have it.

15:11 - We don't we we protect that information.

15:13 - That is just information in our website.

15:15 - And it's really just intended to give you an estimate of,

15:18 - are you going to get $300 of a tax credit off the cost of insurance or $1,000?

15:23 - It really depends.

15:24 - But then you'll know right away what type of premium tax credit you're looking at.

15:29 - You can then go into look at the plans available

15:32 - with that tax credit estimate.

15:36 - You can also look for your doctors that you have.

15:38 - You can tell us what prescriptions you need and generally

15:43 - how much health care you use.

15:44 - Not a lot, a lot.

15:46 - And that helps us, share information about the plans that are available

15:50 - in a way that's tailored to you.

15:52 - So then when you look at the plans, you can see all of health plans

15:55 - from different insurance companies, apples to apples, you see how much they cost.

15:59 - You see what the deductibles or copays may be.

16:02 - You can tell which ones have your doctor and network, which ones

16:06 - have your prescription drug in the formulary,

16:08 - and a lot of other information about what is covered

16:12 - under these different health plans.

16:14 - So if you see one there and you look at the premium and you say,

16:16 - okay, with the premium tax credit, I can make that work in my budget.

16:20 - Then you proceed to, to click enroll and you can continue with that health plan.

16:24 - And then you work with the insurance company.

16:26 - From then on there,

16:27 - you get an insurance card just like you would any other private health plan.

16:31 - And you, you move from there.

16:32 - And again, if you need help at any step throughout that process,

16:36 - then you can

16:37 - get help from agents of brokers, local community organizations.

16:41 - And Penny has, a call center as well.

16:45 - There is, you know, you get that estimate and then once you get the estimate,

16:48 - there is a full application process that will ask more detailed information.

16:52 - That'll make sure that's for information to verify that you're you.

16:55 - So it'll make sure you know that Bob Smith in Pittsburgh is actually Bob

16:58 - Smith in Pittsburgh.

16:59 - And then, you know, you complete other information with more detailed,

17:04 - more detailed information about your income, about,

17:08 - and each offers of job coverage, because you're not allowed to

17:11 - get tax credits if you have job coverage that's affordable, things like that.

17:14 - So it kind of goes in more depth across those different questions.

17:17 - And then you'll sort of get that final,

17:20 - that final premium tax credit.

17:22 - That will you. That's usually pretty in line with the estimate.

17:25 - And then you can finalize the coverage.

17:26 - But that's really what the process field like how many,

17:29 - how many carriers participate in, insurance carriers.

17:33 - This is the shameless plug portion of the program.

17:36 - So how many how many carriers

17:39 - participate on the exchange?

17:41 - There are nine medical carriers that participate.

17:44 - Not all of them participate in the whole state.

17:46 - So some areas where I live in Lancaster, we have seven,

17:51 - some air, other areas have 2 or 3.

17:53 - But what we do see is that people have a lot of choices wherever they live.

17:57 - In Pennsylvania, there is a really competitive and competitive.

18:00 - It's good for consumers because it means insurance companies like capital

18:03 - have to make sure they're putting their their best products forward,

18:07 - for Pennsylvanians.

18:09 - And so we do have a lot of good options in Penny.

18:13 - And that is, you know, we've really seen people appreciate having, choices.

18:18 - And, you know, within a companies, many of them offer several different plans.

18:23 - And that really gives people great options to find

18:25 - what works for you, for both your budget and your health care needs.

18:29 - I just have to say, I've,

18:32 - helped a member of my extended family enroll in Penny.

18:36 - It's very easy.

18:38 - It's direct, and it's,

18:41 - it's very helpful.

18:41 - So thank you for all that you do there.

18:43 - Now, let's let's get into what really matters here.

18:47 - And that's the cost of the product. And,

18:51 - the challenge in health insurance is cost.

18:55 - The products I sell, unfortunately very expensive.

18:58 - And so purchasing something on the exchange

19:04 - is expensive.

19:05 - You've mentioned, on a couple of occasions, we're

19:07 - going to dive into the, the, the the enhanced premium tax credits.

19:13 - Explain most.

19:15 - You know, you and I talk about this a lot.

19:18 - A lot of folks don't know what that means.

19:20 - Try to explain to to the audience

19:24 - who may not understand how all of this works.

19:29 - What is the enhanced premium tax credit?

19:33 - How is it?

19:34 - You know, where does the money come from?

19:37 - Is that tax credit forever?

19:40 - Is it something that they have to qualify for yearly?

19:45 - All of those types of things.

19:46 - Let's start at the beginning and tell us about the tax credit.

19:50 - Where did it start.

19:51 - How did how did it come about.

19:53 - Yeah.

19:54 - So the premium tax credit is really a way to make sure that the health plans

20:00 - that are high quality are also affordable.

20:03 - Because, you know, you can put the consumer protections in place.

20:06 - You can say you have to cover preexisting conditions, things like that.

20:09 - And that does mean that the plans cost a certain amount.

20:13 - And what is then clear over time is

20:16 - that cost is the most important factor of whether people enroll or not.

20:19 - And so, under the Affordable Care Act, starting the marketplaces,

20:24 - the premium tax credits were really intended

20:26 - to address the affordability issue so that people could both

20:29 - get high quality plans, but also at a cost that you can afford.

20:34 - And so it took an approach where based on income.

20:38 - So it's sliding scale.

20:39 - So people who make less pay less for their coverage, they pay 10 or $50

20:43 - a month.

20:44 - People who make more pay more for their coverage may be closer to that.

20:47 - That full cost of a few hundred dollars a month.

20:52 - And so those premium tax credits had been in place

20:55 - since 2014, when the marketplace marketplaces started nationally.

20:58 - Now, in 2021, additional tax credits called enhanced

21:02 - tax credits were put in place to make coverage more affordable.

21:07 - Enrollment had steadily increased over the first few years,

21:11 - but it was clear that there were still an affordability problem.

21:14 - And so the federal government made the tax credits more generous, both to people

21:19 - who had coverage, who had tax credits already and made them higher.

21:22 - And then also there previously was an income cliff

21:26 - where people who made more than that income didn't get any tax credits at all.

21:30 - So today that income is about $60,000 for an individual,

21:34 - or about $82,000 for a couple.

21:36 - And it kind of changes on household size.

21:38 - But those are the the baseline numbers.

21:40 - So now people above that income with the enhanced

21:44 - tax credits can also get tax credits.

21:47 - And they're capped at about 8.5% of income.

21:50 - So when you look at that altogether the enhanced tax credits

21:54 - make the affordability

21:57 - the plans more affordable than ever and for more people than ever.

22:01 - So now,

22:04 - before you go

22:04 - further, what has happened to enrollment?

22:08 - You know, obviously the initial set of tax credits created an enrollment number.

22:13 - What's happened to enrollment

22:15 - since the enhanced premium tax credits were added to the,

22:19 - to the, to the baseline.

22:22 - So the

22:23 - I guess it makes a very direct correlation, right?

22:26 - The more affordable you make something people want coverage.

22:29 - That's what we've seen. People want it.

22:30 - So the more affordable it's gotten, the more people have been bold.

22:33 - And penny coverage has increased by 50% since they were put in place in 2021.

22:39 - So we are at a record number of people who are getting help

22:43 - and financial protection from health plans through 20 500,000.

22:47 - Half a million Pennsylvanians are now getting that protection.

22:50 - And that is really in large part due to the enhanced tax credits

22:54 - that made coverage more affordable than ever.

22:57 - So it's obviously been been successful.

23:01 - So, just in short, that money that those tax credits

23:05 - are coming to customers from the federal government, correct?

23:09 - Yes. Correct.

23:12 - What's the future look like for those tax credits?

23:14 - I mean, we see, you know, a

23:16 - lot of things happen in Washington, you know, things come and go, programs

23:20 - are, created, and then they sunset, which means they expire.

23:26 - What's what what's the future look like for the enhanced premium tax credits?

23:31 - So the future, very uncertain.

23:33 - So the tax, the enhanced tax credits, the extra affordability piece.

23:38 - Under current law, those expire at the end of this year.

23:41 - So that means that the extra portion, the people above $60,000

23:46 - getting it now would go back to getting no tax credits.

23:50 - And everyone else who is getting a tax credit would see less of it

23:53 - because under current law, the enhanced tax credits

23:57 - were only put in place through 2025,

24:00 - and what needs to happen for them to continue is that

24:02 - Congress would have to act to extend them

24:06 - beyond the end of this year, beyond the end of 2025.

24:11 - What hap what do you what this is your crystal ball.

24:14 - What happens to penny enrollment?

24:19 - And I think I know the answer, but,

24:20 - what happens to penny enrollment if those tax credits go away?

24:25 - We think, unfortunately, many people would have to make the tough decision

24:29 - to drop coverage, or to go to less generous coverage,

24:34 - or, you know, having to make tradeoffs in other parts of their lives,

24:39 - in order to afford coverage that would now be more expensive.

24:43 - And so at a high level, what we see as the enhanced

24:46 - tax credits are not extended is that penny enrollees

24:49 - would pay an average 82% more

24:53 - than what they're paying today, just to keep the same plan to cap

24:57 - for some areas that would be higher would be double.

25:00 - Especially in rural areas,

25:02 - where the class structures are a little different.

25:05 - So rural areas would be hit more, suburban and rural areas would be hit more,

25:10 - and closer to that, that doubling of premium.

25:13 - And, you know, we what we hear from people, especially,

25:16 - for example, many of our enrollees are small business owners, is that there's

25:19 - a direct trade off between what they pay for something like health insurance

25:24 - and how much money they have to invest in their small business.

25:27 - So the more money

25:27 - that's going to health insurance, the less is going to their small business.

25:32 - If again, more money is consumed by health insurance premiums,

25:35 - that could result in them having to change their business

25:38 - or increase their prices, which would push,

25:41 - you know, those higher costs through to local economies.

25:44 - So there are a lot of ripple effects from that.

25:47 - So there are people who could, you know, try

25:49 - to keep their coverage by taking, money from elsewhere.

25:54 - But then there are other people who don't have anywhere to take any money from.

25:57 - But there's, you know, the budgets are already tight.

26:00 - There's there's no wiggle room.

26:01 - So any increase, especially to the magnitude of doubling what someone pays,

26:07 - what we've seen, what we've heard directly from penny enrollees

26:10 - is that they just won't be able to do that.

26:12 - And so what happens then is those people would become uninsured.

26:16 - And on a personal level, that means they're putting themselves at risk.

26:20 - You know, they they're not catching diseases early.

26:22 - If they get in a car accident or have some unexpected injury,

26:26 - you know, they're putting themselves

26:26 - at risk of going into medical debt and this or medical bankruptcy.

26:30 - And this is these are all the things that health coverage helps prevent against.

26:35 - So when you go uninsured,

26:37 - that those are the risks that, you know, people tell us that

26:40 - they're really, you know, afraid of having to make those trade offs

26:44 - and at a higher level that has ripple effects as well.

26:48 - With there's higher uninsured rates in Pennsylvania.

26:51 - That means hospitals are getting less reimbursements.

26:53 - They have that higher uncompensated care.

26:55 - So it puts hospitals more at risk financially as well.

26:59 - And it should be noted that, you know, between

27:02 - all these health care provisions and especially the enhanced tax credits,

27:05 - Pennsylvania has the lowest uninsured rate that it's ever had.

27:10 - Sitting around a little bit over 5%.

27:12 - And so to reverse some of the policies that got us here would mean

27:16 - we would reverse some of those those trends that we're seeing.

27:20 - Two questions about that last comment, and I'm going to get to the,

27:24 - the the 5% uninsured, rate in a second.

27:28 - But let let's just, you know, peel away,

27:34 - some of the,

27:37 - of the layers here.

27:39 - Most of us get our health insurance from our employer.

27:43 - And with that

27:46 - too many.

27:48 - This is a lobbyist for health insurance company.

27:50 - Too many people

27:51 - don't really have a good handle on just how expensive this product is.

27:57 - So we've been talking about in generalities it.

27:59 - Can we put some numbers to this?

28:02 - What is a base?

28:04 - What does a basic plan?

28:08 - And I know there are different levels and we can talk about that too.

28:11 - What does a basic plan cost

28:15 - without any tax credits on the exchange?

28:19 - So it's a little bit a tricky question

28:21 - because it really depends on age and geography.

28:25 - So so what people pay is not uniform across.

28:27 - But what I can say is that generally older people pay more, younger

28:31 - people pay less.

28:33 - And rural areas usually pay a little bit more,

28:37 - and in urban areas usually pay a little bit less.

28:39 - But maybe I can give you an example.

28:42 - The reason I'm asking is okay, the reason I'm asking is people

28:45 - here, we're you and I understand this and a lot of the people are on this,

28:50 - on this webinar live do as well.

28:53 - But the average person that you know, is

28:56 - it is it $1,000 a year or is it $5,000 a year,

29:00 - or is it $15,000 a year, or is it $20,000 a year?

29:04 - That's where I what I'm digging that and, and and you know, what does that mean?

29:09 - This is a very expensive product.

29:11 - And if we can put a number to it that I think that might be helpful.

29:15 - Yeah, I would say the

29:18 - kind of balancing all the, the variability

29:20 - the average is usually tend to be around $500

29:24 - a month per a for one person.

29:27 - Now that's sort of person middle.

29:30 - So it's at $6,000 a year, $6,000 a year.

29:33 - Okay. Yeah.

29:34 - But I can give an example of what this looks like for older population.

29:38 - So take for example, 60 year old couple in York County

29:44 - who collectively make $82,000 a year, so 41,000 each,

29:49 - they're older, so their premiums can be higher.

29:52 - So right now they pay with the enhanced tax credits.

29:56 - About $600 a month or $7,000

30:01 - a year for their health insurance.

30:03 - Without the enhanced tax credits, they're slightly above that

30:07 - income cliff that we talked about earlier.

30:10 - They don't have to pay full price, which for them is $3,000 a month

30:15 - or $36,000 a year.

30:18 - So $36,000 a year when they only make 82,000,

30:23 - that's almost half of their income.

30:25 - Just going to health insurance premiums.

30:28 - And so those are the types of situations that we're very concerned about.

30:33 - Well, simply look at that cost and say,

30:35 - I can't pay half of my income, just a health insurance premiums.

30:39 - And so, you know, if you think about when you're 60, there's

30:43 - health conditions that emerge at frequently at those ages.

30:47 - And so what is that costing to them. Right.

30:50 - If they go uninsured in terms of not detecting things early,

30:53 - not being able to treat things early?

30:56 - And really, you know, kind of putting yourselves in the shoes of some of those,

30:59 - those families of those tough decisions that people would have to make.

31:02 - So just to be clear, the example you gave me without the premium

31:07 - tax credit, that couple pays $36,000 a year out of pocket

31:13 - with the premium tax credit.

31:16 - They pay $600 a year.

31:19 - Is that that's 7000 a year.

31:21 - So $600 a month, 7000, $7,000 a year.

31:25 - So it's a difference from 36,000 without the tax credit to 7000

31:29 - with the tax credit.

31:30 - So that's definitely going to make a difference in somebody's

31:35 - bank account. So okay.

31:37 - That's very good.

31:40 - You mentioned we still even with the good work

31:43 - that Penny does and all of the efforts

31:46 - that people have,

31:49 - employer based coverage,

31:51 - there's a population that's on Medicaid, there's a population that's on chip.

31:56 - We still have 5%, uninsured.

32:00 - Tell you tell the audience

32:02 - or explain to the audience who that population is.

32:05 - Who are these folks that in spite of the best efforts of

32:10 - federal government, the state government,

32:13 - you know,

32:13 - businesses, whatever are still uninsured?

32:17 - Yeah, I mean, it it's a lot of different, pockets of people.

32:21 - And I think, you know,

32:22 - that is another value of being a state based marketplace is that pennies spent,

32:25 - we spent a lot of our time trying to answer that exact question of

32:28 - who is uninsured, who can we,

32:31 - make sure knows that that penny is an option for them?

32:35 - I would say there's a couple of broader trends.

32:37 - It tends to be,

32:39 - people who are younger, who are uninsured, many people can stay on their parent's

32:43 - plan until 26, but not everyone has that option.

32:47 - Sometimes people in this age group

32:50 - are less concerned about getting some more of those chronic diseases.

32:54 - But, you know, I think what we when we talk to people

32:57 - who are younger and uninsured, you know, we ask them about,

33:00 - you know, what would they do if they got in a car accident or,

33:03 - got an injury playing softball.

33:05 - I think

33:05 - my husband and then we are in our 20s who's playing an office softball league,

33:09 - and he tore his patellar tendon in his knee

33:11 - and needed to be ambulance to the hospital and then have surgery

33:16 - and so he could walk again, you know, and we had insurance.

33:19 - But without insurance, I mean, that is

33:21 - tens of thousands of dollars, if not more of, of medical coverage.

33:25 - And we considered ourselves pretty healthy at the time.

33:27 - So just goes to show it, you know, it can it can kind of happen at any time.

33:31 - So that's one group,

33:32 - I would say people who are younger, who think maybe I don't need it, but,

33:36 - you know, no one can really predict, what what happens with,

33:40 - with their health.

33:41 - And then,

33:42 - I think, you know, a lot of people who aren't aware just simply

33:46 - aren't aware that they have options.

33:47 - And it seems like every time I go out

33:49 - and talk with people, I run into someone who has a cousin who,

33:53 - you know, has a home contracting business, and he kind of runs it himself,

33:57 - and he doesn't have health coverage

33:58 - because he didn't realize there was anything out there,

34:01 - that he could depend on to be high quality that he could afford.

34:04 - So, I hear all the time about people who just aren't aware

34:07 - that there are options, through the marketplace, like Penny.

34:11 - And then I think, you know, there's also,

34:14 - people in rural areas tend to be more uninsured.

34:17 - You know, I think there's a lot of health care challenges in rural areas.

34:20 - So, you know, part, parcel of that.

34:25 - But, yeah, so those are some of the general trends that we see

34:28 - now, you, you mentioned, you know, and this is

34:32 - this is the the health insurance lobbyist talking to the executive director.

34:36 - You talk about people who still are unaware of options.

34:41 - And, you know, okay, my my question is,

34:47 - you guys, Penny spends a lot of money in outreach.

34:52 - They're always looking for,

34:54 - partners in areas to try to advance,

34:58 - the idea of Penny and to, let the population in those areas

35:03 - know this is an option

35:06 - or what can what else could we do?

35:08 - What new or innovative outreach, approaches

35:13 - can we use to try to get to that, to that group of people who still

35:19 - might be oblivious to the fact that Penny exists and that there is premium support

35:24 - on it,

35:25 - and that they could actually have health insurance,

35:29 - if they, looked into it a little bit more.

35:34 - Yeah.

35:35 - So I would say I think what we have been doing is working.

35:39 - We, we've grown the marketplace over the past,

35:42 - four years by 150,000 Pennsylvanians.

35:44 - So we are getting the word out, but we know we can always do more.

35:48 - So I agree I agree with you on that. Sure.

35:50 - That we and we are always seeking to figure out how can we understand,

35:54 - the uninsured population even more?

35:56 - What are the challenges? What are the concerns?

35:58 - Do they trust health insurance plans?

36:00 - You know, have they had type of experiences?

36:02 - Have they had in the past, and really trying to to meet people

36:06 - where they're at to make sure that they are aware of Penny as an option.

36:09 - And we are, continuing to refine and evolve our outreach approaches,

36:14 - including by expanding,

36:17 - our connection with local community organizations across Pennsylvania,

36:20 - which I think is a huge opportunity that we're very excited about.

36:23 - Just to help us get the word out a bit more.

36:26 - And then I think another thing, people can always do it

36:29 - if you know about Penny or if you are listening now

36:31 - and you're thinking of someone you know that doesn't have coverage,

36:36 - word of mouth is actually

36:37 - the best way that people hear that we we find again and again.

36:40 - That word of mouth is how people find out about Penny.

36:42 - So if you have a friend or a grandkid or you know, a cousin or someone

36:48 - who you know, you know that doesn't get coverage through their employer.

36:51 - And so it's, you know, helpful to say, hey, we do have coverage

36:55 - and do you know about Penny?

36:56 - Because we do see that, that's often how people find out about it.

37:00 - Outstanding.

37:02 - And full disclosure, you guys do a great job

37:04 - in in the outreach, which, you know, the, it never ceases to amaze me

37:09 - with all that organizations do, to to push

37:14 - health care

37:15 - and health insurance and and the and and

37:19 - and the status the issue plays nationally

37:23 - that people still are unaware of what goes on. So,

37:28 - I was just, you know, you guys do a great job.

37:31 - So what else is there to to to reach out to that group now?

37:36 - If we if you don't mind, I'm going to transition.

37:38 - I do represent a health insurance company.

37:40 - So we're going to talk about,

37:41 - some of the, of the we're going to get into the weeds a little bit.

37:45 - So hopefully the folks at home on PCN will indulge me for a second.

37:50 - We're going to talk about some parts of Penny that are that are important,

37:54 - that every part is important to insurance company, but some,

37:58 - that are probably specifically only important to the insurance company.

38:02 - And that's the reinsurance program.

38:06 - And, and I

38:08 - please explain it.

38:09 - You're obviously going to have some people that are watching on,

38:12 - PCN that aren't going to, to know what it means.

38:16 - So if you can explain it, so that I, I guess,

38:20 - a five year old can understand it if a five year old can understand

38:22 - reinsurance, but that's a that's a different question.

38:25 - But explain what reinsurance is.

38:27 - What's the value,

38:29 - that it brings to, obviously insurance companies and to the customer.

38:33 - If you could do that.

38:34 - Yeah. Please. Absolutely.

38:36 - So an reinsurance is sort of an,

38:39 - an insurance for insurance companies, if you will.

38:41 - And it's, it really what it does is, when there are people

38:44 - who are very, very sick and in lots and lots of coverage,

38:49 - sometimes if there's a, if those people are sort of focused

38:52 - in, in one insurance company that increases costs for everyone

38:56 - because those costs have to kind of be spread across everyone who buys insurance.

39:00 - So what reinsurance does is it

39:02 - helps cover some of those costs for the the sickest

39:05 - of the sickest of our neighbors and friends here in Pennsylvania.

39:08 - So they still get the coverage in the care they need.

39:12 - But at the same time, it doesn't have that

39:14 - broader impact on costs for everybody else.

39:17 - So it kind of allows and the program that, that Penny helps fund,

39:23 - to keep those costs

39:26 - lower, for everyone, even if there are a lot of,

39:31 - people with really high health care needs, in a kind of a win

39:34 - win, you know, make sure people get they, they get the care they need

39:38 - while also not having that sort of larger cost increases.

39:42 - So part of Penny's budget, we go to feed into helping reduce,

39:46 - you know, helping kind of pay for some of those,

39:50 - those people who have the highest of high

39:51 - needs, to help keep those, those costs lower.

39:54 - And that's a program in

39:55 - by the Pennsylvania Insurance Department that we work very closely with.

39:59 - On that.

40:00 - And that's a very unique way that our insurance marketplace was set up.

40:04 - Just going back to your question earlier

40:05 - about what's what's great about being at the state level,

40:09 - we're really sort of the only marketplace set up where we both fund our operations,

40:13 - but we also fund the, part of the reinsurance program to help

40:16 - keep costs lower for everybody, even those who don't get the premium tax credits.

40:22 - So that that's a really important program and something that's been very unique

40:25 - to Pennsylvania.

40:27 - I will make one more connection

40:28 - just to the enhanced tax credit. So,

40:32 - if the enhanced tax credits are not extended

40:35 - and the pool of people who are covered through Penny goes down,

40:39 - it does limit our ability to support that program.

40:42 - We will still be able to support it

40:44 - in some way, but we will have less money to do that.

40:47 - And so it becomes sort of,

40:51 - you know, bed on top of that, if they're not extended and that,

40:53 - you know,

40:54 - people's costs would increase because they're not getting as much tax credit,

40:58 - but also we wouldn't be able to help keep costs as low for everyone else also.

41:03 - So it kind of has that broader impact.

41:07 - It it does. Absolutely.

41:08 - And thank you for that.

41:09 - Now I guess we've we've kind of

41:14 - circled

41:15 - the issue and that is affordability, right?

41:19 - We've we've circled it

41:20 - in terms of the affordability for the customer, affordability in terms

41:24 - of, of of the products that that my company offers, etc., etc..

41:29 - The question and, and and this is, I guess

41:32 - maybe this is just you and I talking about it.

41:36 - How do we get our hands around?

41:39 - The affordability issue because you're, you're dealing with it

41:42 - in terms of providing affordable options

41:46 - to customers, as am I.

41:50 - But there's always also

41:52 - an affordability challenge for what I pay for.

41:55 - Right?

41:55 - The claims that I pay for are just

41:58 - astronomical and they're going up.

42:00 - And so, you know, in your role, I mean, obviously you're not directly

42:05 - in, in line of sight of those challenges,

42:09 - but how just to people in the health care space, how do we get our hands

42:13 - around the affordability problem because it is

42:16 - swamping us, because you're

42:21 - you offer a product that without

42:24 - government help, substantial government help, people can't afford it on their own.

42:27 - How do we get a handle on that?

42:29 - Curious what your thoughts are if you were queen for a day?

42:32 - Yeah.

42:34 - Tough question. Right?

42:35 - Easy question, easy question.

42:38 - I mean, the fact is that costs and increasing

42:41 - healthcare costs have been the source of discussion.

42:45 - And solution hunting for everyone

42:49 - at every level who works in the health care system for decades.

42:53 - Right. This is not if there was a silver bullet.

42:56 - We would have found it already.

42:58 - There is no silver bullet.

42:59 - The health care system is a very complex

43:02 - and inter tangled,

43:06 - system, an ecosystem that has really,

43:09 - I think at this point feels unwieldy to a lot of people.

43:12 - And how to address that, that cost issue, not that we shouldn't try.

43:17 - So I think, you know,

43:18 - speaking from the perspective of the marketplace, you know,

43:21 - we don't have a lot of levers to kind of we're kind of at the end of the stream.

43:25 - And the way I view it is that people who get their coverage

43:29 - through Penny, that the premiums are high because of those upstream costs.

43:35 - And, you know, the position I take from my role as executive director

43:39 - is that the people who come to buy coverage,

43:41 - the penny, shouldn't bear the burden of our collective inability

43:45 - to do something about the cost upstream.

43:47 - We should we should continue to try to do that.

43:49 - But until then, we should avoid having,

43:53 - you know, a relatively small population that doesn't get coverage elsewhere,

43:57 - kind of pay the maximum price for our collective inability to do that.

44:01 - I mean, I think it's a it is a collective problem that requires

44:03 - collective solutions, and it's not on any one stakeholder or party.

44:08 - But, you know, I think that is where we think about affordability

44:11 - from the marketplace perspective, is

44:13 - how do we make sure people can still get access?

44:15 - While yes, we have to address these other issues, these bigger cost problems,

44:20 - but if we don't have affordable, you know,

44:22 - with help of reducing the premiums, then then it's really, you know,

44:27 - someone who runs a small business is paying the full price.

44:29 - They certainly can't control those upstream costs either.

44:32 - And they're not responsible for those.

44:33 - So I think, you know, we see it as making sure that until and while we continue

44:38 - to search as a society for solutions to the cost problem,

44:42 - making sure that, you know, there aren't segments of

44:45 - people just simply locked out of life saving health care.

44:49 - Because of sort of broader things that are happening in the marketplace.

44:53 - Yeah.

44:53 - Thank you for that. I think.

44:56 - And then my, you know, my next question is.

45:03 - Assuming all things are

45:05 - tax credits or extend right.

45:08 - And that's a heck of an assumption.

45:10 - And I know, you and I, have had this conversation

45:13 - in different forums, before, but that's a heck of an assumption

45:17 - to assume that those tax credits are in place.

45:21 - But moving forward, if everything looks at Penny

45:24 - as it does today,

45:27 - what's next?

45:28 - Are there new innovations?

45:29 - Whether they be technological or products or whatever?

45:34 - What can the people of Pennsylvania expect

45:38 - in the future from Penny churn?

45:41 - Well, I'll give you a vision and a and a caution, to.

45:45 - So I think what we try to do with Penny is

45:47 - make sure the coverage is as affordable as it can possibly be.

45:51 - And, as as simple to enroll as that can possibly be.

45:55 - We're always looking for ways to cut out stops so that people don't have

45:58 - to submit information twice or repeat something they've already done.

46:02 - Always looking for ways, you know, because we know

46:04 - people are busy, they have other things on their mind.

46:06 - They don't think about health insurance all day like we do.

46:08 - So like our goals.

46:10 - To make them think about it is, you know, as

46:12 - little as possible in terms of having it be an easy process without issues.

46:16 - And on the affordability front, you know, we mentioned that

46:19 - we support this reinsurance program that helps lower costs.

46:23 - We also, you know, have been working with the state legislature on,

46:27 - you know, other potential state options to make coverage more affordable.

46:31 - Even with all the federal tax credits in place,

46:35 - 60% of penny enrollees still say the coverage is barely affordable.

46:40 - So they're they're they're paying for it, but it is, you know,

46:42 - on the cusp of being across that line to affordable, unaffordable.

46:46 - And then 80% of the uninsured say

46:49 - the main reason they don't get covered is because of cost.

46:52 - So, you know, the more that we could do from kind of state solutions

46:56 - that wrap around, we're, you know, in active discussions on those, about

47:00 - is there a way from Pennsylvania's perspective

47:03 - that we can make that coverage more affordable and accessible?

47:05 - So, you know, we're always looking at new ideas

47:08 - to, again, make that coverage easier, to get easier to enroll in.

47:13 - So that's sort of where we want to go.

47:16 - I will caution, though, that,

47:17 - you know, we talked a lot about the enhanced tax credits.

47:20 - There are other federal changes that play in the reconciliation bill.

47:24 - So sitting here in June, nothing's final yet, you know, but we are watching,

47:29 - the reconciliation bill because it does include provisions

47:32 - that make coverage more expensive through the marketplace,

47:36 - even on top of the enhanced tax credits expiring.

47:40 - And it also puts in new limits and process

47:44 - steps and red tape that would make it harder to enroll.

47:47 - And for people who currently has coverage to keep that coverage.

47:51 - So we are, you know, can you give me give some more detail, the viewer

47:55 - more detail what that looks like those challenges look like.

47:59 - Yeah.

47:59 - So there would be additional again if finalized sitting here and do nothing

48:04 - final yet.

48:04 - But there are provisions that would,

48:07 - require people to submit, you know, come back more frequently,

48:11 - submit more information, or regularly, even if it's something you know

48:15 - from our perspective that we believe

48:16 - we already information we already have, that we've already verified, it would,

48:20 - you know, add in some duplicative steps to what we already do today.

48:25 - That would really add more steps on

48:28 - the side of someone looking for coverage,

48:30 - and it would reduce the amount of time people have to look for coverage.

48:33 - Basically, you know, other complicated processes

48:37 - that we would have to follow because it would be federal law.

48:39 - So we wouldn't be able to just cut those steps out.

48:42 - But additional steps that if someone happens to miss a key

48:45 - part of that step, they would be locked out of coverage.

48:48 - And, you know, when you take a lot of those all together,

48:51 - the chance that someone misses a step here misses a step there.

48:54 - That just increases the more and more steps you add on.

48:57 - On to being able to enroll.

48:59 - So we are watching those.

49:00 - We are, you know, communicating the implications of,

49:04 - of what would happen if that would go into place.

49:07 - Because we do think that would,

49:08 - again, lock some people out of coverage who are eligible to enroll.

49:12 - And then there are additional provisions that would make cost even higher

49:15 - for consumers.

49:17 - Starting as soon as January, 15% increase

49:20 - in out-of-pocket costs like deductibles and co-pays and things like that. So,

49:24 - again, you know, we are,

49:26 - you know, doing our part to educate policymakers on the impacts

49:30 - we think this would have on our enrollees because we hear from from you

49:33 - all the time.

49:34 - And, you know, I think watching that very carefully,

49:38 - to see what what happens and, you know, whatever ends up being finalized.

49:42 - Okay. Okay.

49:45 - Now, are there any

49:48 - moving forward, are there any, additional,

49:52 - medical benefits?

49:53 - I mean, you know, I'll just ask it directly.

49:56 - We hear it all the time.

49:57 - Will Penny offer vision coverage in the future?

50:00 - Yeah, I think it right at the moment, it's medical and dental, but not vision.

50:04 - Will it will it expand to include vision at any point in the future?

50:10 - So that's

50:10 - one of those cases where we really have to look at federal law.

50:13 - So the marketplace is under federal law, our,

50:17 - to have health plans and dental plans.

50:19 - But vision is wasn't called out is something to include.

50:24 - So, that's one of those places where, you know, we're a little bit

50:27 - limited by, the federal rules around our program.

50:30 - Okay. Okay.

50:34 - We've talked a,

50:36 - a lot about, the enhanced

50:38 - premium tax credits.

50:41 - And Penny in, in general, I'm curious

50:45 - if you have, and I'll give you,

50:48 - you know, the last word, so to speak, if you have a parting message

50:53 - for whoever's watching,

50:55 - whether it's a customer, whether it's a prospective customer,

50:58 - whether it is a, member of Congress or, elected official of some sort.

51:04 - What what would be the message that you would want to give them, about Penny,

51:10 - moving forward?

51:12 - Sure.

51:13 - Well, thank you for the the final floor.

51:16 - So I guess I'd have two different messages.

51:17 - One would be to people who don't have coverage today to,

51:20 - really emphasize that Penny is an option for you.

51:24 - We have high quality coverage with all those consumer protections

51:27 - and are the only place for that coverage to be more affordable.

51:30 - So if you don't have coverage and this is sort of piqued your interest,

51:34 - please do come to our website, Pennekamp

51:37 - and iee.com and check out your options.

51:41 - You if you're uninsured right now, you do need a special enrollment

51:45 - period to enroll.

51:46 - But if you don't have that, if you don't qualify for a major life

51:49 - change, open enrollment starts just a couple just a few months from now,

51:52 - November 1st. So really keep that in mind.

51:55 - You know, coverage really does make sure you can get that medical care

51:58 - when you need it and protects against

52:00 - you know, medical bankruptcy and things like that.

52:03 - For those who do have coverage and, you know, generally I would say,

52:07 - tell tell your story.

52:08 - I mean, I think that's a really important part

52:10 - right now, both to, your friends who may not have coverage to, you know,

52:14 - explain to them why you have coverage and why you think it,

52:18 - really gives you that protection to to continue building your life.

52:22 - But also, I think, you know, we do a lot of education with policymakers

52:26 - about the statistics, the data, the impacts of what

52:29 - cost would increase and for what populations.

52:32 - And what we see, is most compelling at the end of the day

52:37 - is then knowing how it personally impacts people they know or,

52:42 - or people they walk across in the grocery store or,

52:47 - really just anything.

52:47 - And so what Penny does is

52:48 - we try to elevate those stories when we have them to really just,

52:52 - you know, give voice to, hey, this is really what it means

52:55 - for someone who, a current enrollee in,

52:59 - eastern Pennsylvania who has cancer and he's luckily in remission.

53:03 - But it is something that he needs to constantly monitor and need coverage.

53:07 - He's in his 30s, you know, it's not, something he expected to be dealing

53:11 - with at this time, but needs that coverage to get him through.

53:14 - And, you know, I think the more that,

53:17 - people tell their stories and talk about what it means

53:20 - to have the health and financial security of having health coverage,

53:24 - it does really help

53:28 - people truly understand how important it is

53:30 - and what a lifeline it is for many Pennsylvanians.

53:34 - We do have more information about, especially the enhanced

53:37 - tax credits on our website.

53:39 - And that's penny.com/costs.

53:42 - And at the bottom of that page, there's actually a chance

53:44 - if you want to talk about how important penny coverage is to you,

53:48 - there's a form that can be filled out at the bottom.

53:51 - And we just, you know, again, we just use that information to help, really.

53:54 - And it's not just about the numbers.

53:56 - It's about our friends, our families, our neighbors who

54:01 - this coverage is, is a lifeline.

54:02 - It's the difference between getting sick and staying sick

54:06 - or getting sick and being healthy and being able to thrive again.

54:10 - So that would be my parting message is to tell your story to a friend or to funny,

54:15 - so that we can continue to make sure that people really understand how important

54:19 - this coverage is. Well, thank you for that.

54:22 - And that is a wonderful final word.

54:24 - Please keep up the good work that you're doing at Penny.

54:28 - And the advocacy on behalf of, Pennsylvania residents,

54:32 - ladies and gentlemen, that ends this, episode of the Public Affairs Forum.

54:36 - We want to thank Devon Trolley for, appearing today.

54:41 - And we'll probably going to take a little bit of a hiatus

54:44 - for the rest of the summer.

54:44 - You can probably get the

54:46 - the next episode of the Public Affairs Forum, probably sometime in September.

54:51 - So thank you again, Devon, for joining us and have a nice day, everybody.

54:56 - Thank you. Thank you so much.

55:12 - And. The Capital

55:30 - Blue Cross Forum is sponsored in part by Capital Blue Cross.