SLS 13RS-787 ORIGINAL Page 1 of 5 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. Regular Session, 2013 SENATE BILL NO. 246 BY SENATOR NEVERS FUNDS/FUNDING. Provides for the dedication of revenues realized from the expansion of health insurance coverage pursuant to the Affordable Care Act. (8/1/13) AN ACT1 To enact Subpart O-1 of Part II-A of Chapter 1 of Subtitle I of Title 39 of the Louisiana2 Revised Statutes of 1950, to be comprised of R.S. 39:100.65, relative to the3 dedication of certain revenues; to establish the Health Care Insurance Coverage4 Equity Fund in the state treasury; to provide for the dedication of monies to and5 deposits into the fund; to provide for the use of monies in the fund; and to provide6 for related matters.7 Be it enacted by the Legislature of Louisiana:8 Section 1. Subpart O-1 of Part II-A of Chapter 1 of Subtitle I of Title 39 of the9 Louisiana Revised Statutes of 1950, comprised of R.S. 39:100.65, is hereby enacted to read10 as follows:11 SUBPART O-1. HEALTH CARE INSURANCE COVERAGE EQUITY FUND12 §100.65. Health Care Insurance Coverage Equity Fund13 A. As used in this Subpart, except where the context requires otherwise,14 the following terms shall have the meaning ascribed to them in this Section:15 (1) "ACA" and "Affordable Care Act" mean the following acts of16 congress, collectively:17 SB NO. 246 SLS 13RS-787 ORIGINAL Page 2 of 5 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. (a) The Patient Protection and Affordable Care Act, which originated1 as H.R. 3590 in the One Hundred Eleventh United States Congress and became2 Public Law 111-148.3 (b) The Health Care and Education Reconciliation Act, which originated4 as H.R. 4872 in the One Hundred Eleventh United States Congress and became5 Public Law 111-152.6 (2) "Department" means the Department of Health and Hospitals.7 (3) "Health Benefit Exchange" means the vehicle created to help8 individuals, families, and small businesses in Louisiana shop for and select9 health insurance coverage in a way that permits comparison of available10 Qualified Health Plans based upon price, benefits, services, and quality,11 regardless of the governance structure of the exchange, as provided in the ACA.12 (4) "Medicaid" means the medical assistance program provided for in13 Title XIX of the Social Security Act.14 (5) "Qualified Health Plan" means an individual health insurance plan15 offered by a carrier through the Health Benefit Exchange, as provided in the16 ACA.17 B. There is hereby established in the state treasury, as a special fund, the18 Health Care Insurance Coverage Equity Fund, hereinafter referred to as the19 "fund".20 C. The source of monies deposited into the fund shall be:21 (1) Any state savings realized in uncompensated care cost payments22 which would no longer be necessary because of the expansion of health23 insurance coverage options resulting from both an expansion of the state24 Medicaid program and the creation of a Health Benefit Exchange pursuant to25 opportunities afforded the states under the Affordable Care Act, after first26 having been credited to the Bond Security and Redemption Fund as required27 by Article VII, Section 9(B) of the Constitution of Louisiana.28 (2) Taxes collected under the provisions of R.S. 22:842 from health care29 SB NO. 246 SLS 13RS-787 ORIGINAL Page 3 of 5 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. premium assessments paid for new policies written as a result of or through the1 Health Benefit Exchange created for the state of Louisiana pursuant to the2 Affordable Care Act after first having been credited to the Bond Security and3 Redemption Fund as required by Article VII, Section 9(B) of the Constitution4 of Louisiana.5 (3) Any monies appropriated by the legislature, including donations,6 gifts, grants, or any other monies, which may be provided by law.7 (4) Deposits to the fund from the sources set forth in Paragraphs (1) and8 (2) of this Subsection shall not occur unless and until the federal government9 gives approval for the expansion to the Medicaid program via amendment to10 the Medicaid state plan or federal waiver utilizing a private insurance option11 that includes premium assistance and supplemental cost sharing subsidies.12 D. Monies in the fund shall be invested in the same manner as monies13 in the state general fund. Interest earned on the investment of monies shall be14 deposited in and credited to the fund. Unexpended and unencumbered monies15 in the fund at the end of the fiscal year shall remain in the fund.16 E. Subject to legislative appropriation, monies in the fund shall be17 appropriated to the department solely to provide for:18 (1) Future obligations of any expansion of the Medicaid program as19 approved by the federal government through amendments to the Medicaid state20 plan or federal waivers utilizing a private insurance option that includes21 premium assistance and supplemental cost sharing subsidies for eligible22 individuals to enroll in a qualified health plan through the Health Benefit23 Exchange created pursuant to the Affordable Care Act. Such expansion24 program shall be designed through legislative enactment to reform the25 Medicaid program so that it is a fiscally sustainable, cost-effective, personally26 responsible, and opportunity-driven program utilizing competitive and value-27 based purchasing to:28 (a) Maximize the available service options.29 SB NO. 246 SLS 13RS-787 ORIGINAL Page 4 of 5 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. (b) Promote accountability, personal responsibility, and transparency.1 (c) Encourage and reward health outcomes and responsible choices.2 (d) Promote efficiencies that will deliver value to the taxpayers.3 (2) The development and implementation of a strategy to inform4 Medicaid recipient populations whose needs would be reduced or better served5 through participation in the Health Benefit Exchange.6 The original instrument and the following digest, which constitutes no part of the legislative instrument, were prepared by Martha S. Hess. DIGEST Proposed law establishes the Health Care Insurance Coverage Equity Fund, hereinafter the "fund", as a special fund in the state treasury. Proposed law provides the source of monies deposited into the fund shall be: (1)Any state savings realized in uncompensated care cost payments which would no longer be necessary because of the expansion of health insurance coverage options resulting from both an expansion of the state Medicaid program and the creation of a Health Benefit Exchange pursuant to opportunities afforded the states under the Affordable Care Act, after first having been credited to the Bond Security and Redemption Fund. (2)Taxes collected under the provisions of R.S. 22:842 from health care premium assessments paid for new policies written as a result of or through the Health Benefit Exchange created for the state of Louisiana pursuant to the Affordable Care Act after first having been credited to the Bond Security and Redemption Fund. (3)Any monies appropriated by the legislature, including donations, gifts, grants, or any other monies, which may be provided by law. Proposed law further provides that deposits to the fund from the sources set forth in Paragraphs (1) and (2) of this Subsection shall not occur unless and until the federal government gives approval for the expansion to the Medicaid program via amendment to the Medicaid state plan or federal waiver utilizing a private insurance option that includes premium assistance and supplemental cost sharing subsidies. Proposed law provides that subject to legislative appropriation, monies in the fund shall be appropriated to the Department of Health and Hospitals solely to provide for: (1)Future obligations of any expansion of the Medicaid program as approved by the federal government through amendments to the Medicaid state plan or federal waivers utilizing a private insurance option that includes premium assistance and supplemental cost sharing subsidies for eligible individuals to enroll in a qualified health plan through the Health Benefit Exchange created pursuant to the Affordable Care Act. Such expansion program shall be designed through legislative enactment to reform the Medicaid program so that it is a fiscally sustainable, cost-effective, personally responsible, and opportunity-driven program utilizing competitive and value-based purchasing to: (a)Maximize the available service options. SB NO. 246 SLS 13RS-787 ORIGINAL Page 5 of 5 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. (b)Promote accountability, personal responsibility, and transparency. (c)Encourage and reward health outcomes and responsible choices. (d)Promote efficiencies that will deliver value to the taxpayers. (2)The development and implementation of a strategy to inform Medicaid recipient populations whose needs would be reduced or better served through participation in the Health Benefit Exchange. Effective August 1, 2013. (Adds R.S. 39:100.65)