Relating to the creation of a health insurance risk pool for certain health benefit plan enrollees; authorizing an assessment.
If enacted, HB 3851 would introduce a new framework within Texas insurance law that allows for the formation and governance of a health insurance risk pool. The bill outlines the responsibilities of a board of directors that will oversee the administration of the pool, including the management of funding through federal money and the assessment of health benefit plan issuers to cover operational expenses. Notably, the program will not be subject to state taxes or fees, enhancing its viability and attractiveness to potential enrollees.
House Bill 3851 proposes the establishment of a health insurance risk pool intended to support individuals enrolled in health benefit plans under specific criteria. This risk pool aims to function as a reinsurance mechanism that would mitigate the financial impact of high-risk individuals on health insurance premiums within the individual market. By this means, the bill intends to achieve a significant reduction in premiums, making health insurance more affordable and encouraging higher enrollment rates in guaranteed issue plans.
While proponents argue that the risk pool will alleviate costs for high-risk individuals and expand access to affordable health insurance, concerns have been raised regarding the potential implications of this program on the existing insurance market. Critics may highlight the need for careful public oversight and stakeholder engagement in the planned operations of the pool and the long-term sustainability of funding sourced from health plan assessments. Furthermore, the bill's requirement for federal waivers could also complicate its implementation, depending on the response from the federal government.