Pennsylvania Is a State-Based Exchange Using a Federal Platform for 2020

On July 2, 2019, Pennsylvania Governor Tom Wolf signed House Bill 3 (now Act 42 of 2019) into law to create a state-based exchange (SBE) in Pennsylvania and begin a two-year transition from the current federally-facilitated Marketplace through to the SBE. Full transition to the SBE is slated for the 2021 Open Enrollment period and at that time the commonwealth will host its own website, navigator programs, call center and marketing and outreach. For this 2020 transition year, PACHC has been awarded sole state funding to operate the Navigator Program under the Pennsylvania Health Insurance Exchange Authority. Since implementation of the ACA in 2010, Pennsylvania has relied on the federal health insurance exchange. To cover costs, the federal government charged insurers a 3.5 percent fee on premiums paid by ACA enrollees each month, a projected $98 million for Pennsylvania insurers in 2019. This user fee is expected to be cut to 3% beginning in 2020, decreasing the amount to approximately $88 million. Pennsylvania will continue to use to enroll consumers for 2020 coverage, to calculate premium tax credits and to enroll consumers eligible for special enrollment periods.