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Many in Pennsylvania can still get benefit of Affordable Care Act

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Thursday, Aug. 21, 2014, 10:54 p.m.

Alicia Donner left her job with an environmental nonprofit last month, a move that cost her employer-sponsored health coverage.

But the 27-year-old from Wilkinsburg wasn't worried — she enrolled in a health plan through the online marketplace established under the Affordable Care Act.

Even though open enrollment on ended on March 31 and won't start again until Nov. 15, Donner qualified for a special enrollment period because she no longer had a job that provided coverage.

There are about 61,000 uninsured Pennsylvanians who could gain coverage because they lost their jobs, got divorced or moved, according to estimates from Enroll America, a nonprofit group that advocates for President Obama's health overhaul law.

“While we made great strides in getting Pennsylvanians covered during the first open enrollment period, there are still many who remain uninsured and unaware of their new options,” said Bill England, state director of Enroll America's Get Covered campaign.

Enroll America's analysis used Census data to estimate how many people typically experience one of the qualifying “life events” laid out under the Affordable Care Act that trigger a special enrollment period.

For Donner, the ability to pick up federally subsidized health insurance made her decision to quit working full time and explore other careers less stressful.

“It was just time for a change,” she said. “And being able to get a health plan made me realize it was time for change, and I would be OK without a full-time job for a while.”

Donner said the coverage on the federal exchange costs about $140 a month after a $60 subsidy. She couldn't recall how much she paid for health insurance under her former employer's plan.

The Congressional Budget Office in February predicted that many Americans would choose to work less because they no longer relied on an employer for health insurance. The CBO report estimated a decline of 2 million full-time-equivalent jobs in 2017.

“The estimated reduction stems almost entirely from a net decline in the amount of labor that workers choose to supply, rather than from a net drop in businesses' demand for labor,” the report stated.

Donner chose a plan from Highmark Inc., the state's largest health insurer and one of the dominant carriers on the federal exchange in Pennsylvania.

From the beginning of April through Wednesday, about 40,000 people in Pennsylvania have enrolled in a Highmark health plan through special enrollment, spokeswoman Adrienne Baldini said.

Helping Donner to enroll was a navigator from the Consumer Health Coalition, a North Side nonprofit group that helps the uninsured sign up for coverage available on the federal exchange.

Antoinette Kraus, interim executive director, said that since April the coalition has seen an average of three to four people a week who are seeking special enrollment assistance since April.

“It's a lot of folks who are changing jobs or lost employment,” she said. “That's probably about 75 percent of our enrollment.”

Alex Nixon is a staff writer for Trib Total Media. He can be reached at 412-320-7928 or

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