What is the legal framework for health insurance?

In Pennsylvania, health insurance is regulated by a combination of federal and state laws. At the federal level, the Affordable Care Act (ACA) establishes a national framework for health insurance. The ACA creates regulations and subsidies for individual and group health insurance plans, including the creation of the Health Insurance Marketplace where individuals can shop for and compare health plans. At the state level, Pennsylvania has adopted the ACA’s legal framework for health insurance and implemented additional laws, regulations, and programs to ensure citizens have access to quality health care. Under Pennsylvania law, all employers with 50 or more full-time employees must offer health insurance to their employees or face penalties. Additionally, companies that provide health insurance must follow specific rules and regulations to ensure quality care. State and federal laws also protect vulnerable populations from being denied coverage. For example, the ACA prevents insurers from denying coverage because of pre-existing conditions, while the Pennsylvania Human Relations Act prohibits insurers from denying coverage to individuals based on their age, race, color, creed, religion, ancestry, sex, or national origin. These laws create a legal framework for health insurance that helps ensure individuals in Pennsylvania have access to affordable, quality health care.

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What is the legal framework for health insurance?

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