In his first speech to a joint session of Congress, President Donald Trump Tuesday night urged the House and Senate to make good on a promise to repeal and replace the Affordable Care Act.
In doing so, the president endorsed a key provision of a Republican plan in the House: providing tax credits to help consumers.
"We should help Americans purchase their own coverage, through the use of tax credits and expanded Health Savings Accounts - but it must be the plan they want, not the plan forced on them by the government," Trump said.
However, divisions appear to be emerging in the Republican-controlled U.S. House and Senate, as conservatives have said the tax credits amount to a costly new entitlement.
In the meantime, Gov. Tom Wolf's administration has urged members of the state's congressional delegation not to completely dismantle Obamacare.
“Focus on building on the progress we’ve made since the health law was passed instead of undoing the system and starting from scratch," said Pennsylvania Insurance Commissioner Teresa Miller.
According to Miller, the percentage of Pennsylvanians without health coverage dropped from 10.2 percent prior to the Affordable Care Act to 6.4 percent in 2015.
“We also know that Pennsylvanians have really benefited, millions of them from expanded access to really critical benefits including preventive health services, for example," Miller said. "It also expanded access to maternity care and mental health services."
However, Pennsylvanians who must purchase their own health insurance are paying much more for the coverage—a statewide average increase of 32 percent in 2017, according to the Insurance Department. In the Pittsburgh region, those increases are as much as 56 percent, which was more than the two major insurers, UPMC and Highmark requested.
Miller said the state offers assistance to some individual buyers to offset the high cost of insurance.
“But there are about 1 to 2 percent of Pennsylvanians who are in that individual market, but not eligible for financial assistance," she said. "And that's really where when we talk about the ACA is not working as well as it could for everyone, it’s true."
Miller acknowledged that Obamacare is likely to be repealed, but she said she hopes that any replacement should include people with pre-existing conditions, preventative care, like routine exams and cancer screenings and that individuals don’t lose coverage if they reach “lifetime limits” on medical costs.
Miller added that she believes the debate over Obamacare and health coverage has ignored a basic component.
“The reason that health insurance is expensive is because the care that it covers and pays for is expensive," she said. "And unfortunately we've really not been addressing how do we get at those costs because that's how we're going to get health insurance costs (down) ultimately."
The Associated Press contributed to this report.
