Q&A with Pennie Executive Director Devon Trolley
Devon Trolley took the reins of Pennie, the state-based insurance marketplace, in 2023, replacing the program's founding executive director, Zach Sherman. She has focused her work on expanding access to quality and affordable health insurance. City & State spoke with Trolley on the latest legislative efforts in Harrisburg to address insurance affordability – and what many people may not know about the state's insurance marketplace.
The interview has been edited for length and clarity.
Where did your interest in the health policy space begin, and how did it lead you down this professional path?
I really caught the policy bug after I did an undergraduate-master's combined program, I went to Washington, D.C. through the Winston Health Policy Fellowship. It was a few months of talking to everyone in D.C., in and outside the government and across the whole entire political spectrum of think tanks. As part of that fellowship, I had the opportunity to work in the Senate during the Affordable Care Act, and worked on some of the policies that were included in that law.
Once that passed, I knew the rest of my career I'd either be implementing or working on some aspect of that – just because it was so transformative, and it focused on the uninsured and people who can't access the health care system when they need it. Your health insurance card is your key to the medical system, and if you don't have that, you don't get access to preventive care.
What's the most common misconception you hear about Pennie?
There are a couple of misconceptions. One is the claim that "it's private coverage, it's out of my price range." But the truth is, nine in 10 people receive financial savings based on a unique type of tax credit that you get right away. On average, that is $500 in savings. For example, instead of paying $600 a month that you would pay for a high-quality plan, we have ones for $50 and $100 – and what you pay per month is based on what you make, a sliding scale. We hear from people regularly that it's much more affordable than they thought it would be.
Some people still think it's not quite affordable enough. We think it's a lack of awareness, people not even knowing that there is something that exists if you don't get coverage through your job or Medicare or Medicaid.
We're trying to make sure there's more awareness that there is an option out there ... We're really the only place to come to get high-quality plans that are at a lower cost.
There's a proposal in Harrisburg to provide new subsidies to help individuals pay for their insurance premiums. What are your thoughts on that issue?
We're hopeful that the affordability program will come to full fruition. We have a couple of steps in place, and we're very much looking forward to bringing that program to life because we do, unfortunately, hear every day from people who want to enroll and it's just too much for them to get that coverage. Another benefit is that people can buy up to better coverage, a plan with lower deductibles and lower pocket costs. There are benefits across the board of that proposal that we're hoping comes to fruition.
What is the current status of the enhanced premium tax credits?
They expire at the end of 2025. There is a very large affordability focus right now. It's about providing information to leaders about the impact of not extending those; we sent a letter to the delegation with a lot of specific impacts on what that would do. But the amount that people pay per month would increase in some places by more than double. Those tax credits have allowed us to reach record numbers of enrollment through the marketplace. We are highly concerned about them not continuing.
Is it safe to say that accessibility and affordability are at the forefront of your priorities?
Yes, exactly. The enhanced premium tax credit from the federal perspective has eased the transition from Medicaid to Pennie. With Medicaid, there is not really a monthly cost. So if you make a little too much for Medicaid, when you come over to Pennie to look for a private plan, many of those individuals can find plans for zero monthly premiums or under $10 a month – and with a state affordability program, we could build on that to reach even more higher-income levels.
