Section 202-G. Affordability Assistance Program.
(a) Establishment.--The Affordability Assistance Program is established under the exchange authority. Beginning in plan year 2025, the affordability assistance program shall incentivize enrollment in health insurance policies offered on the exchange as specified under subsection (b) contingent on funds being available under section 203-G.
(b) Financial assistance.--The affordability assistance program shall provide financial assistance to eligible individuals purchasing a health insurance policy through the exchange. The exchange authority shall determine the amount of financial assistance based on the adjusted gross income of an individual. The following shall apply:
(1) An individual who has an adjusted gross income that is not lower than 151% of the Federal poverty limit and does not exceed 300% of the Federal poverty limit shall be an eligible individual for financial assistance under the affordability assistance program.
(2) An individual or household with adjusted gross income that is less than 150% of the Federal poverty limit, but is not eligible for the medical assistance program may be deemed an eligible individual for financial assistance under the affordability assistance program upon the expiration for any reason of Federal subsidies used to incentivize the purchase of health insurance policies through the exchange provided under the American Rescue Plan.
(c) Limitations.--Financial assistance to an eligible individual under this section may not be used to incentivize the purchase of a bronze level plan defined in 42 U.S.C. § 18022 (relating to essential health benefits requirements).
(d) Requirements of exchange authority.--The affordability assistance program shall be subject to 40 Pa.C.S. Ch. 93 (relating to State-based exchange) pertaining to statutory requirements on the operations of the exchange authority, including 40 Pa.C.S. §§ 9310 (relating to audits) and 9311 (relating to reports).
(202-G added July 11, 2024, P.L.550, No.54)