Purpose. This request for proposals (RFP) provides to those interested in submitting proposals for the subject procurement (“Offerors”) sufficient information to enable them to prepare and submit proposals for the Pennsylvania Health Insurance Exchange Authority’s consideration on behalf of the Commonwealth of Pennsylvania (“Commonwealth”) to satisfy a need for Media Buying Services (“Project”). This RFP contains instructions governing the requested proposals, including the requirements for the information and material to be included; a description of the service to be provided; requirements which Offerors must meet to be eligible for consideration; general evaluation criteria; and other requirements specific to this RFP.
Pennsylvania initially opted not to establish its own exchange (although the state seriously considered establishing its own exchange in 2015, when the King v. Burwell lawsuit threatened premium subsidy access in states that didn’t run their own exchanges). So for the first several years of ACA implementation, Pennsylvania has used the federally run exchange at HealthCare.gov. But Pennsylvania enacted legislation (H.B.3/Act 42) in 2019 that calls for the state to transition to running its own exchange platform and also create a reinsurance program that will help to make coverage more affordable.
The state will need to obtain federal approval (via a 1332 waiver, which the state submitted in February 2020) in order to have federal funding for the reinsurance program. But that’s expected to be granted in the summer of 2020, so that the reinsurance program can take effect in 2021. And the process of creating the state-run exchange — which will be known as Pennie — is well underway.
New Jersey is also working towards having its own exchanges in 2021; New Mexico and Maine are planning a similar transition for the following year.
Pennsylvania has nine carriers participating in the exchange market for 2020, although some of them offer plans via multiple subsidiaries. Ambetter from PA Health & Wellness joined the exchange for 2019, offering plans in the Philadelphia area, and Oscar joined the exchange for 2020, also offering plans in the Philadelphia area.
Average premiums in Pennsylvania’s individual market decreased slightly for 2019, and although they increased by an average of almost 4 percent for 2020, a rate decrease could come again in 2021, thanks to the transition to a state-run exchange and the implementation of a reinsurance program.
Pennsylvania exchange applicants are enrolled in Medicaid if their income is up to 138 percent of the poverty level, and 685,809 people were enrolled in the state’s expanded Medicaid program as of December 2019. This was slightly lower than the enrollment total in late 2018, so enrollment in Pennsylvania’s expanded Medicaid, which took effect in 2015, appears to have stabilized.
The expansion of Medicaid is a major cornerstone of Obamacare; many enrollees supported Trump in the 2016 election, perhaps unaware that the reason they have access to Medicaid in Pennsylvania is a result of the ACA (Obamacare).
Another 279,881 people were receiving premium subsidies to offset the cost of private coverage purchased through the Pennsylvania exchange as of mid-2019. All told, there are nearly a million people in Pennsylvania who are receiving either expanded Medicaid or premium subsidies in the exchange to make private coverage more affordable.
Governor Tom Wolf announced in September 2017 that the uninsured rate in Pennsylvania had fallen to 5.6 percent as of 2016 — the lowest it had ever been, and down from nearly 10 percent before the ACA was implemented.
Scope of Work:
Overview of Project. The Pennsylvania Health Insurance Exchange Authority (Exchange Authority) is a state-affiliated entity established on July 2, 2019 by Act 42. The Exchange Authority is charged with the responsibility of creating a state-based health insurance exchange, assisting in the reduction of health insurance costs, and better supporting the needs of consumers purchasing health insurance in the individual market. The Exchange Authority’s new technology platform and customer service operations will replace the existing federal health marketplace, HealthCare.Gov, for health insurance plan year 2021. As such, the Exchange Authority will play a critical role in ensuring the stability, affordability, and accessibility of the individual health insurance market for the benefit of hundreds of thousands of Pennsylvanians who rely on the health insurance exchange for health insurance coverage. Additional information about the Exchange Authority or Act 42 is available at the following website: www.insurance.pa.gov/SBEINFO. This procurement seeks a vendor to provide media buying services for the Exchange Authority to enhance brand awareness, educate, and increase sales of individual health insurance coverage in Pennsylvania.
Offeror will develop a media purchasing strategy and purchase the subsequently approved advertisements for the object of increasing enrollment in and awareness of the availability of health coverage offered by the Exchange Authority.
Offeror to use campaign assets to target (and retarget) multiple audiences as necessary to raise awareness of the Exchange Authority and the insurance products Page 6 of 32 sold on the Exchange Authority’s platform. Offeror will also conduct market and audience research and develop strategic approaches for conducting targeted efforts aimed at achieving the Exchange Authority’s overall goal.