Reinsurance Program Overview
Pennsylvania's Section 1332 Waiver Reinsurance Program uses funds from the Pennsylvania Health Insurance Exchange Authority (Pennie®) combined with federal funds saved by the program to partially reimburse insurance companies for costs associated with high-cost claims in the individual market. The reimbursement allows insurers to set lower premiums for all individuals purchasing their health insurance through the individual market.
The primary goal of the reinsurance program is to promote a competitive and equitable insurance market for consumers. The program benefits are particularly important for those who do not qualify for federal tax credits. Pennsylvania’s reinsurance program is "invisible" to consumers, who continue to enroll in coverage and seek care under their policies as they always have.
The program was first approved in 2020. When waiver applications are approved, they go into effect for up to five years, with an opportunity to apply for five-year extensions. An application to extend the waiver was approved in 2025, continuing the program from January 1, 2026, through December 31, 2030.
Program Impact
Since the start of Pennsylvania's reinsurance program, we have seen premiums decrease by a range of 4-6% annually, a steady increase in individuals enrolled in the individual market, and a decrease in the number Pennsylvanians without insurance.
Change in Pennsylvania's Individual Enrollment* | |
|---|---|
| Year | Enrollment |
| 2020 | 393,000 |
| 2021 | 414,000 |
| 2022 | 432,000 |
| 2023 | 440,900 |
| 2024 | 488,200 |
Change in Pennsylvania's Uninsured Rate† | |
|---|---|
| Year | Uninsured Rate |
| 2014 | 9.7% |
| 2022 | 5.3% |
Table Footnotes:
*Enrollment rounded to nearest thousand. Increase in enrollment is driven by multiple factors, including federal initiatives to enhance subsidies.
† Uninsured Rates: American Community Survey - Health Insurance Coverage Status and Type of Coverage by State and Age for All People.