The program will initially operate for up to five years and will begin in 2023. The CHRP will reimburse ACA individual market payers for a percentage of a member’s claims costs that exceed a specified threshold and up to a specified ceiling. In 2023, the approved program would reimburse claims between $40,000 and $155,000 with a coinsurance rate of 70 percent. The program is projected to reduce individual marketplace premiums by 15.6 percent in 2023, and aims to eventually reduce them by up to 20 percent.
Submitting the application to establish the program was required under a state law passed in 2021, HB 2332. The program is being funded through state general funds and federal pass-through funding provided under the waiver.
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