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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
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(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 Insurance Marketplace" means the federal vehicle created8
to help individuals, families, and small businesses shop for and select health9
insurance coverage in a way that permits comparison of available qualified10
health plans based upon price, benefits, services, and quality, regardless of the11
governance structure of the marketplace.12
(4) "Medicaid" means the medical assistance program provided for in13
Title XIX of the Social Security Act.14
(5) "Qualified Health Plan" means a federally certified individual health15
insurance plan offered by a carrier through the federal Health Insurance16
Marketplace.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 Insurance Marketplace25
pursuant to opportunities afforded the states under the Affordable Care Act,26
after first having been credited to the Bond Security and Redemption Fund as27
required 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
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premium assessments paid for new policies written as a result of or through the1
Health Insurance Marketplace 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, including but not limited to utilizing11
a private insurance option that includes premium assistance and supplemental12
cost sharing subsidies.13
D. Monies in the fund shall be invested in the same manner as monies14
in the state general fund. Interest earned on the investment of monies shall be15
deposited in and credited to the fund. Unexpended and unencumbered monies16
in the fund at the end of the fiscal year shall remain in the fund.17
E. Subject to legislative appropriation, monies in the fund shall be18
appropriated to the department solely to provide for:19
(1) Future obligations of any expansion of the Medicaid program as20
approved by the federal government through amendments to the Medicaid state21
plan or federal waivers, including but not limited to utilizing a private22
insurance option that includes premium assistance and supplemental cost23
sharing subsidies for eligible individuals to enroll in a qualified health plan24
through the Health Insurance Marketplace created pursuant to the Affordable25
Care Act. Such expansion program shall be designed to reform the Medicaid26
program so that it is a fiscally sustainable, cost-effective, personally responsible,27
and opportunity-driven program utilizing competitive and value-based28
purchasing to:29 SB NO. 246
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(a) Maximize the available service options.1
(b) Promote accountability, personal responsibility, and transparency.2
(c) Encourage and reward health outcomes and responsible choices.3
(d) Promote efficiencies that will deliver value to the taxpayers.4
(2) The development and implementation of a strategy to inform5
Medicaid recipient populations whose needs would be reduced or better served6
through participation in the Health Insurance Marketplace.7
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Martha S. Hess.
DIGEST
Nevers SB No. 246
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 Insurance Marketplace 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
Insurance Marketplace 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, including but not limited to 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 Insurance Marketplace created pursuant to the
Affordable Care Act. Such expansion program shall be designed 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 SB NO. 246
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
purchasing to:
(a)Maximize the available service options.
(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 Insurance Marketplace.
Effective August 1, 2013.
(Adds R.S. 39:100.65)
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Finance to the original
bill
1. Changes name of "Health Benefit Exchange" to "Health Insurance
Marketplace" and revises definition.
2. Revises definition of Qualified Health Plan.
3. Provides that federal approval to the Medicaid state plan or federal waiver
may include, but not be limited to utilizing a private insurance option.
4. Deletes reference to legislative enactment in the design of the expansion
program.