Tens of thousands of Pennsylvanians will be shopping for new health insurance plans for next year when open enrollment begins on Nov. 1.

Experts urge consumers to be aware of exactly what they are getting. More 680,000 Pennsylvania residents do not have health insurance, according to the Kaiser Family Foundation.

Zachary Sherman, executive director of Pennie.com, the state's online insurance marketplace, said the website is where to start if you are shopping for an individual health plan.

"Pennie is a place for Pennsylvanians who don't have access to job-based coverage or medical assistance, or Medicare," Sherman explained. "It's for those who don't have access to affordable coverage, for them to go to access high-quality, affordable health insurance plans. Very importantly, it's the only place to get savings on coverage to lower your monthly premiums."

The Inflation Reduction Act passed by Congress extended the Affordable Care Act's premium subsidies through 2025, so the same subsidy rules in effect this year will continue for 2023. Sherman added if the subsidies had not been extended, Pennsylvanians would be spending about 20% more on their health coverage for next year.

Dr. Rhonda Randall, chief medical officer for UnitedHealthcare employer and individual, noted there are some options people may not think about, such as how a plan would handle a significant health event, like a pregnancy or chronic health condition. She added since the pandemic, more people also have recognized the benefits of getting care online.

"Plans that include virtual care services for both medical conditions as well as behavioral health conditions have become very popular," Randall pointed out. "We've seen the utilization of those increase. You're also looking for a plan that has not only virtual health options, but a connection to in-person care as well."

Randall emphasized adding dental, vision or hearing coverage is another consideration, as well as double-checking whether the plan covers the prescriptions you need. In short, she recommends people do their homework, as enrollment dates are fast approaching.

The New York State Legislature is considering a bill to allow the creation of public banks. The New York Public Banking Act would authorize municipal and other local governments to form and control public banks through ownership interests such as capital stock. The hope is these banks will invest in community endeavors rather than interests in line with making the bank profit. A report from the Rainforest Action Network said some of the largest banks in the nation are heavily invested in the fossil-fuel industry despite world policy shifts to renewable energies.

Mike Sandmel, senior campaign organizer with New Economy Project, said public banks present benefits to municipalities invested in them.

"Broadly speaking, it is a great tool for investing in infrastructure. This is a great tool for investing in affordable housing; for investing in small business creation," he said.

The recent turmoil following the failure of Signature Bank has influenced interest in public banking. Numerous organizations and elected officials across the state signed a letter
to the Majority Leader of the State Senate and the Speaker of the Assembly supporting the bill.

Primary opposition to the bill, currently under review by the Senate Banking Committee, has come from Wall Street banks trying to keep the business these cities bring, Sandmel said.

Previous versions of the bill were brought before the Legislature in the past two sessions, but never advanced beyond the Banking Committee. Sandmel is hopeful it will pass this year, but even if it does, work remains to outline local government's terms for a public bank, he said.

"We have to have conversations in local communities about is this something we want to do? Is this something we think we can pull off? What does our business plan look like? What does our application look like? You have to pass legislation, locally, right. Through city councils or county legislatures. To authorize actually doing that work of putting that business plan together," he said.

Other actions are being taken to make banks more accountable to the people whose money they hold, outside of this bill. New York City's Banking Commission
will include a public comment process for their public hearing to designate banks eligible for holding deposits of city funds.

The Consumer Financial Protection Bureau has proposed new regulations on credit card late fees, which could save Americans billions of dollars.

The bureau reported late fees cost cardholders about $12 billion a year. Congress attempted to ban excessive late fees in 2009, but the Federal Reserve still allowed companies to charge late fees up to $41. The new proposal would lower it to $8 and end an automatic yearly inflation adjustment for the fee amount.

Overall, the regulation would cap late fees at 25% of the minimum payment.

Daniel Rathfelder, vice president for card services for Coastal Federal Credit Union, said the new rules would help cardholders.

"I think overall, consumers are going to see some big pieces shift in their favor, if that gets adopted," Rathfelder observed.

Late fees are intended to cover collection costs, and some card issuers increase the fees with each additional missed payment. Under the proposal, companies would still be able to charge higher fees, if they can prove their collection costs are higher. The bureau estimated the new rule would save people as much as $9 billion a year. The agency is taking public comments until April 3.

The bureau also wants public comments on the possibility of a 15-day grace period beyond the due date before late fees can be assessed. Rathfelder noted in its public comment on the rule change, his credit union endorsed the idea.

"We pushed a little bit harder and said if consumers had a grace period, and the companies who could do automation around messaging and notification, getting people after the first day that it's due a notice saying, 'Hey, you missed this, but you have nine more days,' that would probably resolve a lot of the scenarios," Rathfelder explained.

Rathfelder added some enclaves of the financial services industry have already adopted grace periods, including for auto loans and mortgages.

New research shows Nevada's small-business owners say hospital consolidation in the state is exacerbating high health-care costs and want action to be taken.

More than one thousand business owners participated in Small Business for America's Future's most recent survey, and 94% of them reported hospital consolidation has made the overall availability and quality of health care in their communities worse.

Co-chair of the group Shaundell Newsome said they want to see more "fairness and equity" when it comes to accessible health care.

"When it goes from bad to worse, that is very tough on our small businesses," said Newsome. "And nearly half of the small-business owners say that hospital consolidation leads to a lack of competition, and makes hospital services more expensive for our employees."

According to the report, almost half of small-business owners say the lack of competition has made hospital services more expensive, while eating away at employees' pay.

Newsome - a small business owner himself - said he would love to be able to provide better health-care options to his employees, which he says cultivates a better workforce.

Newsome said Nevada is in need of more diverse providers, but not through consolidation.

He added that Nevada's recent progress in expanding access to health care is under threat - and said rather than reversing the progress that has been made, small business owners would like to see policy and lawmakers "double down" on making health care more affordable.

Newsome said this report reaffirms that sentiment.

"The rising cost of health care," said Newsome, "just basically limits an entrepreneur's ability to invest in the growth and the financial health of our businesses."

A majority of those surveyed in Nevada say it's time for the federal and state governments to intervene in the consolidation of health systems.




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