The election outcome and your health care: What’s next

Development of a health insurance exchange and whether or not to expand Medicaid are just two of the major health-care decisions facing our Commonwealth.
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20 Under 40: JenniferDessoye

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Dr. Jennifer Dessoye is assistant professor of occupational therapy at Misericordia University and owner of Bright Beginnings Early Learning Academy (BBELA). Discontent with the early education curriculum and understanding of human development and neurolo (read more)

20 Under 40: Amy Hlavaty Belcher

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Amy Hlavaty Belcher, 39, owner and artistic director of Abrabesque Academy of Dancing, believes that for those who have been given much, much is expected. “I just try hard to do my best,” she said. I have been blessed with many opportunities and many gift (read more)

20 Under 40: Christopher Hetro

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Chris Hetro, 33, works hard and plays hard. “A strong work ethic is important, but finding balance outside of work is important because life is too short and you need to enjoy it,” he explained. As an electrical engineer and project manager at Borton-Laws (read more)

20 Under 40: C. David Pedri

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For attorney C. David Pedri, 37, it’s all about a combination of qualities that contribute to success. “My philosophy is simple: be open and honest, treat people the way you would want to be treated, with respect, and work hard to attain your dreams. The (read more)

20 Under 40: Ed Frable

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Ed Frable, 28, believes “if I work hard and stick to my word, good things will happen. My crew will not be deterred. We will re-evaluate our game plan and not give up until the job is complete,” explained Frable, the owner/operator of Ed Frable Constructi (read more)

20 Under 40: William H. Bender II

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William H. Bender II, CFP, CIMA, CRPC, loves what he does. “I’m lucky. I come to work every day excited to help the people and institutions we work with,” explained Bender, 34, first vice president at Bender Wealth Management Group, Merrill Lynch. The fam (read more)

20 Under 40: Angelo Venditti

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Angelo Venditti, 38, heard a call to the helping professions early on. Geisinger Northeast’s chief nursing officer answer was to volunteer for his local fire company. After high school, he became a paramedic, then enrolled in nursing school. Three years a (read more)

20 Under 40: Donald Mammano

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At 20, Donald Mammano began his own company, while attending the University of Scranton. Mammano, now 33, and president of DFM Properties, recalls, as a youngster, holding a flashlight while his father fixed the kitchen sink. “From that point on I was fas (read more)

20 Under 40: William J. Fennie III

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William J. Fennie III, 27, is always knocking on the proverbial door, because he knows one day, one will open. As an investment specialist with Integrated Capital Management (iCM) he cannot take “no” for an answer. “I make cold calls every day to invite f (read more)

20 Under 40: Marcus Magyar

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As an advisor at CAPTRUST Financial Advisors, Marcus N. Magyar, CFP, 30, provides comprehensive wealth management and investment portfolio services to business owners, executives, families and high-net worth individuals. His multi-disciplinary team of pro (read more)

20 Under 40: Heather Davis

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Heather M. Davis, 33, director of marketing and communication, is responsible for creating, overseeing and implementing a strategic marketing and comprehensive communications plan for The Commonwealth Medical College (TCMC). She is also responsible for pr (read more)

20 Under 40: Alexandria Duffney

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Alexandria Duffney, 30, is competitive by nature and loves a good challenge. These qualities have led her to her position as associate director of graduate admission at Wilkes University. Here she works with prospective students interested in enrolling in (read more)

20 Under 40: John Culkin

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John Culkin’s tenets inform: “Less haste equal more speed; the same boiling water that softens the potato hardens the egg, it is all about what you are made of, not the circumstances surrounding you; and don’t ask someone to walk a mile in your shoes, bef (read more)

20 Under 40: Conor O'Brien

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“What could be worse than getting to the end of your life and realizing you hadn’t lived it,” mused Conor O’Brien.” As co-founder and executive director of the Scranton Fringe Festival, O’Brien, 25, is responsible for leading the development of the overal (read more)

20 Under 40: Jessica Siegfried

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Jessica Siegfried, 38, is senior designer with BlackOut Design Inc., where she is responsible for all creative design at the full-service agency, from traditional branding and print to collateral and front end web design. “I’ve always had an interest in t (read more)

20 Under 40: David Johns

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David Johns’ career path has been shaped by his diverse experiences. As director of structural engineering at Greenman-Pedersen Inc., Moosic, Johns, 39, ensures that his engineering and consultant teams provide clients with their best effort. “We complete (read more)

20 Under 40: Robyn Jones

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Robyn Jones, 38, president of ReferLocal LLC, has learned just as many lessons from her business successes as she’s had from her failures — and she believes it’s important to share that knowledge with her employees. After graduating from American Universi (read more)

20 Under 40: Nisha Arora

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Nisha Arora, 36, tries to be the best version of herself every day. As general counsel for ERA One Source Realty Inc., she realized she cannot control other’s behavior so “I try to focus on myself and how I can be better,” she explained. Arora’s responsib (read more)

20 Under 40: Justin Sandy

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Starting at a young age in Hazleton, Justin C. Sandy, 33, found a passion for running. He became a member then a coach for Misericordia University’s cross country and track and field programs. “It was at Misericordia that I also garnered the profound sati (read more)

20 Under 40: Dr. Ariane Conaboy

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As a doctor of internal medicine at Physicians Health Alliance, Dr. Ariane M. Conaboy, 34, realizes the importance of human life and how fragile it can be at times. Conaboy graduated from Scranton Prep and the University of Scranton with a double major in (read more)

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On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA) into law. Since then, Blue Cross of Northeastern Pennsylvania (BCNEPA), other health insurers and the entire health-care industry have been working to implement the law’s numerous provisions, many of which go into effect on Jan. 1, 2014.
Since its passage, the ACA has been a polarizing issue among Americans. Legal challenges to the ACA from a number of states and small business interests resulted in the U.S. Supreme Court ruling on the constitutionality of the ACA this past June. The court ruled that the individual mandate provision and the insurance market reforms included in the law were constitutional. The court’s decision ensured that the ACA remained a cornerstone issue in this year’s presidential election.

The ACA is President Obama’s signature domestic accomplishment. Now that the president has been elected to a second term, we can expect the administration to continue moving toward full implementation of the federal health-care law over the next few years as designed.

Because a major campaign theme for many Republican candidates was a vow to repeal the ACA, many are speculating whether there will be efforts by some in the new Congress to propose changes to this wide-ranging reform law.

Whether or not these forces continue to collide, BCNEPA and other health insurers will remain on the path of ACA implementation as directed under the law and by the Obama Administration. That means that beginning on Jan. 1, 2014 consumers will be able to compare and purchase health insurance plans through an online exchange. Individuals with lower incomes will have access to federal subsidies to help pay for their coverage, and individuals with pre-existing medical conditions will not be denied coverage through the exchange.

We must also remain mindful that implementation of certain major provisions of the ACA — such as establishing health insurance exchanges and whether or not to expand Medicaid eligibility — are decisions now facing individual states.

Nov. 16 was the deadline (since extended) by which states must inform the federal government if the state is prepared to administer its own health insurance exchange or work with the federal government to jointly operate an exchange. If a state is not prepared to pursue either of these paths, then the federal government will step in and administer the exchange.

States must also decide whether or not to expand Medicaid. In its original form, the ACA compelled states to expand Medicaid eligibility to those individuals under the age of 65 who make less than 133 percent of the federal poverty level. The U.S. Supreme Court’s decision in June, however, allows states to choose to participate in this expansion, and Pennsylvania is one of many states that have not yet made this decision.

Development of a health insurance exchange and whether or not to expand Medicaid are just two of the major health-care decisions facing our Commonwealth. On these and other issues, we urge our policy makers to make decisions that retain state control of our health care and health insurance markets, because our commonwealth leaders know our markets and consumers, and are in the strongest position to decide what will work best for all Pennsylvanians.

At the end of the day, it’s important to realize that these measures — and the other insurance market reforms included in the ACA — will not address the driving issue of rising health-care costs. All stakeholders in the health-care system must continue to work toward a unified and multi-faceted approach to addressing the rising costs of care.

For example, health insurers are already working with doctors and hospitals nationwide to implement accountable-care models and other patient-centered payment reforms that reward the quality of care a patient receives. Health insurers are also offering an array of programs that promote wellness and that help manage costly chronic conditions.

As Congress and the president continue to debate health-care policy over the next few years, Blue Cross of Northeastern Pennsylvania urges lawmakers at the national level to turn attention to policies that address the long-term ability to control escalating health-care costs.

Now that the 2012 elections are over, our members — and all residents of the 13 counties we serve — deserve health-care policy at both the state and federal levels that works to control escalating costs through prevention, disease management and wellness; improves access to care; and rewards doctors and hospitals for keeping their patients healthy.

Kimberly J. Kockler is vice president of government affairs for Blue Cross of Northeastern Pennsylvania. The ideas and opinions expressed are solely the author’s and not necessarily those of the Business Journal.