Nine years after the Affordable Care Act, these Pennsylvanians struggle to afford health insurance

When North Side resident Dana Hroblak looked at her hospital bill, she was stunned. It was an invoice for $27,000.

“I remember saying, ‘It’s Monopoly money,’” Hroblak, 27, said of the 2017 charge to have her appendix removed. “There’s no way we could ever pay that, so it was just kind of so shocking that it becomes funny.”
Her husband, a technician at a local university, and their three children are covered by insurance provided by his employer, but adding her to the plan would be too expensive. As a stay-at-home mom, she lacks a separate income and including her would cost $300 per month.
The Affordable Care Act [ACA], a nine-year-old overhaul to the U.S. healthcare system, is intended to make health insurance accessible for everyone by expanding Medicaid and making insurance easier for individuals to buy without an employer. Since its passage and a Pennsylvania’s 2015 expansion of Medicaid, the state saw increases in the percentage of residents covered by insurance. But significant gaps remain.
Hroblak is among about 692,000 Pennsylvanians still lacking health insurance, according to the Pennsylvania Insurance Department.
For her, it’s not for a lack of trying to find a plan that works.
“The ACA doesn’t offer anything that we could afford,” Hroblak said. “I think when I applied for the ACA last May, coverage would still be $200 a month.”
Hroblak and several other Pittsburgh-area residents cited the high cost of insurance as a significant barrier to coverage. Some gamble, forgoing insurance in hopes that they won’t face exorbitant out-of-pocket costs. Others buy coverage but still face high costs for health problems not covered by plans they can afford.
Meanwhile, President Donald Trump’s administration has been working to dismantle the law, first by pushing for Congress to try to gut the law and then by removing the individual mandate. The mandate required Americans and lawful permanent residents without insurance to buy their own or face a penalty.
Against that backdrop and a political fight over whether individuals or the government should pay for insurance, Pennsylvanians like Hroblak are falling through the cracks.


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