PRINTER'S NO. 2977
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
2234
Session of
2024
INTRODUCED BY KIM, SCHLOSSBERG, HILL-EVANS, SANCHEZ,
KOSIEROWSKI, HANBIDGE, HOWARD, MALAGARI, HADDOCK, CEPEDA-
FREYTIZ, McANDREW, ABNEY, GIRAL, WARREN, VENKAT, T. DAVIS,
KHAN, GUENST, SHUSTERMAN, MAYES, SIEGEL AND CERRATO,
APRIL 24, 2024
REFERRED TO COMMITTEE ON INSURANCE, APRIL 24, 2024
AN ACT
Amending Title 40 (Insurance) of the Pennsylvania Consolidated
Statutes, in preliminary provisions relating to health
insurance markets oversight, further providing for
definitions; and, in State-based exchange, further providing
for powers and duties of exchange authority.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 9103 of Title 40 of the Pennsylvania
Consolidated Statutes is amended by adding a definition to read:
§ 9103. Definitions.
Subject to additional definitions contained in subsequent
provisions of this part which are applicable to specific
provisions of this part, the following words and phrases when
used in this part shall have the meanings given to them in this
section unless the context clearly indicates otherwise:
"Affordability assistance program." The affordability
assistance program implemented by the exchange authority under
section 9305(b)(6) (relating to powers and duties of exchange
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authority).
* * *
Section 2. Section 9305(b)(4) and (5) of Title 40 are
amended and the subsection is amended by adding a paragraph to
read:
§ 9305. Powers and duties of exchange authority.
* * *
(b) Programmatic duties.--The exchange authority shall
perform all duties necessary or appropriate to advance its
purpose, including the following:
* * *
(4) Assess and collect fees from on-exchange insurers to
support the operation of the exchange under this chapter and
either the reinsurance program established under section
9502(b) (relating to implementation of waiver and
establishment of reinsurance program) or an affordability
assistance program as described in paragraph (6), or both,
except that the exchange authority may not assess or collect
any form of obligation other than an exchange user fee on
total monthly premiums for on-exchange policies and unless
approved by unanimous consent of the board, the fee may not
exceed 3% of total monthly premiums for on-exchange policies.
In no case may the fee exceed 3.5%.
(5) Disburse receipted fees, including to benefit [the
reinsurance program established under section 9502(b).]:
(i) t he reinsurance program established under
section 9502(b);
(ii) an affordability assistance program in plan
year 2025 as described in paragraph (6), provided that
the commissioner determines that alternative funds are
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available to fund the reinsurance program in a manner
that satisfies the requirements of the Commonwealth's
innovation waiver in accordance with section 1332 of the
Affordable Care Act and transmits notice of the
determination to the Legislative Reference Bureau for
publication in the next available issue of the
Pennsylvania Bulletin; or
(iii) both the reinsurance program under
subparagraph (i) and an affordability assistance program
under subparagraph (ii).
(6) Implement an affordability assistance program in
plan year 2025 to provide a net positive financial impact to
consumers of on-exchange qualified plans in this
Commonwealth. The following apply:
(i) The affordability assistance program shall be
designed to incentivize enrollment in on-exchange
policies based on income or other eligibility criteria.
(ii) The provision of money or benefits accrued
through the affordability assistance program may not
constitute an entitlement derived from the Commonwealth
or a claim on any other money of the Commonwealth.
(iii) The affordability assistance program shall be
subject to all provisions of this chapter pertaining to
the operations of the exchange authority and the exchange
fund, including sections 9310 (relating to audits) and
9311 (relating to reports).
* * *
Section 3. This act shall take effect immediately.
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