PA HB1863

Establishes a Public Option Program within the Pennsylvania Insurance Department to offer health insurance in the individual market through the state-based exchange, with required coverage in the small group market and optional coverage in the large group market

Caps provider and facility reimbursement rates at 160% of Medicare rates for all covered benefits under the program's health insurance policies

Requires premiums to be at least 5% lower than the reference premium in year one, scaling up to 15% lower by year four and beyond

Mandates coverage of all 10 essential health benefits, plus dental, vision, dependent coverage up to age 26, and spousal/domestic partner coverage, with multiple metal-tier levels per ACA requirements

Creates the Public Option Program Fund in the State Treasury, funded by appropriations, grants, and donations, with annual reporting to legislative leadership on enrollment, demographics, premiums, and program funding