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Healthy Pennsylvania Demonstration

According to information provided by the State, this proposed demonstration will allow the state to use premium assistance to purchase qualified health plans offered in the individual market through the Marketplace for individuals who are either (1) childless adults ages 21 to 65 with incomes at or below 133% of the federal poverty level (FPL) or (2) parents/caretaker relatives between the ages of 21 and 65 with incomes between 33 and 133% FPL. The demonstration will also establish a High Risk benefit plan and Low Risk Benefit plan. The demonstration seeks to further the objectives of the Medicaid program by promoting continuity of coverage for adults, improving access to providers, allowing for more coordinated care, and furthering quality improvement and delivery system reform. Pennsylvania has submitted a potential modification to this 1115 submission. CMS is extending the comment period to allow sufficient time for public consideration.

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