Maryland 2025 Regular Session

Maryland Senate Bill SB5 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1
2	2
3	3		EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
4	4		[Brackets] indicate matter deleted from existing law.
5		-	Underlining indicates amendments to bill.
6		-	Strike out indicates matter stricken from the bill by amendment or deleted from the law by
7		-	amendment.
8	5		sb0005
9	6
10	7		SENATE BILL 5
11	8		J5 5lr1634
12		-	(PRE–FILED) ~~CF HB 297~~
	9	+	(PRE–FILED)
13	10		By: Senators Lam, Feldman, and Hayes
14	11		Requested: November 1, 2024
15	12		Introduced and read first time: January 8, 2025
16	13		Assigned to: Finance
17		-	Committee Report: Favorable
18		-	Senate action: Adopted
19		-	Read second time: February 7, 2025
20	14
21		-	~~CHAPTER ______~~
	15	+	A BILL ENTITLED
22	16
23	17		AN ACT concerning 1
24	18
25	19		Maryland Health Benefit Exchange – State–Based Young Adult Health 2
26	20		Insurance Subsidies Pilot Program – Sunset Repeal 3
27	21
28	22		FOR the purpose of renaming the State–Based Young Adult Health Insurance Subsidies 4
29	23		Pilot Program to be the State–Based Young Adult Health Insurance Subsidies 5
30	24		Program; repealing the termination date of certain provisions of law that establish 6
31	25		and govern the funding for the Program; authorizing rather than requiring the 7
32	26		Maryland Health Benefit Exchange to establish and implement the Program; 8
33	27		prohibiting the Exchange from implementing the Program if certain funds are not 9
34	28		available; and generally relating to health insurance subsidies for young adults. 10
35	29
36	30		BY repealing and reenacting, without amendments, 11
37	31		Article – Insurance 12
38	32		Section 31–107(a) 13
39	33		Annotated Code of Maryland 14
40	34		(2017 Replacement Volume and 2024 Supplement) 15
41	35
42	36		BY repealing and reenacting, with amendments, 16
43	37		Article – Insurance 17
44	38		Section 31–107(b), (f)(1)(iv), and (g)(1) and 31–122 18
45	39		Annotated Code of Maryland 19
46	40		(2017 Replacement Volume and 2024 Supplement) 20
47	41
48		-	BY repealing and reenacting, with amendments, 21 2 SENATE BILL 5
	42	+	BY repealing and reenacting, with amendments, 21
	43	+	Chapter 778 of the Acts of the General Assembly of 2021, as amended by Chapters 22
	44	+	256 and 257 of the Acts of the General Assembly of 2023 23
	45	+	Section 2 24
49	46
50		-
51		-	Chapter 778 of the Acts of the General Assembly of 2021, as amended by Chapters 1
52		-	256 and 257 of the Acts of the General Assembly of 2023 2
53		-	Section 2 3
54		-
55		-	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 4
56		-	That the Laws of Maryland read as follows: 5
57		-
58		-	Article – Insurance 6
59		-
60		-	31–107. 7
61		-
62		-	(a) There is a Maryland Health Benefit Exchange Fund. 8
63		-
64		-	(b) (1) The purpose of the Fund is to: 9
65		-
66		-	(i) provide funding for the operation and administration of the 10
67		-	Exchange in carrying out the purposes of the Exchange under this subtitle; 11
68		-
69		-	(ii) provide funding for the establishment and operation of the State 12
70		-	Reinsurance Program authorized under this subtitle; 13
71		-
72		-	(iii) provide funding for the Medical Assistance Program and the 14
73		-	Senior Prescription Drug Assistance Program; 15
74		-
75		-	(iv) provide funding for the establishment and operation of Health 16
76		-	Equity Resource Communities under Title 20, Subtitle 14 of the Health – General Article; 17
77		-	and 18
78		-
79		-	(v) provide funding for the establishment and operation of the 19
80		-	State–Based Young Adult Health Insurance Subsidies [Pilot] Program authorized under 20
81		-	this subtitle. 21
82		-
83		-	(2) The operation and administration of the Exchange, the State 22
84		-	Reinsurance Program, the State–Based Young Adult Health Insurance Subsidies [Pilot] 23
85		-	Program, and the Qualified Resident Enrollment Program may include functions delegated 24
86		-	by the Exchange to a third party under law or by contract. 25
87		-
88		-	(f) (1) The Fund may be used only: 26
89		-
90		-	(iv) for the establishment and operation of the State–Based Young 27
91		-	Adult Health Insurance Subsidies [Pilot] Program. 28
92		-
93		-	(g) (1) The Board shall maintain separate accounts within the Fund for 29
94		-	Exchange operations, for the State Reinsurance Program, and for the State–Based Young 30
95		-	Adult Health Insurance Subsidies [Pilot] Program. 31
96		-
97		-	31–122. 32 SENATE BILL 5 3
	47	+	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 25
	48	+	That the Laws of Maryland read as follows: 26 2 SENATE BILL 5
98	49
99	50
100	51
101		-	(a) In this section, [“Pilot Program”] “PROGRAM” means the State–Based Young 1
102		-	Adult Health Insurance Subsidies [Pilot] Program. 2
	52	+	Article – Insurance 1
103	53
104		-	(b) (1) [The] SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , THE 3
105		-	Exchange, in consultation with the Commissioner and as approved by the Board, [shall] 4
106		-	MAY establish and implement a State–Based Young Adult Health Insurance Subsidies 5
107		-	[Pilot] Program to provide subsidies to young adults for the purchase of health benefit plans 6
108		-	in the individual health insurance market. 7
	54	+	31–107. 2
109	55
110		-	(2) THE EXCHANGE MAY NOT IMPL EMENT THE PROGRAM FOR 8
111		-	CALENDAR YEARS IN WH ICH FUNDS FROM THE DISTRIBUTIO N OF THE ASSESSMENT 9
112		-	UNDER § 6–102.1 OF THIS ARTICLE ARE NOT AVAILABLE . 10
	56	+	(a) There is a Maryland Health Benefit Exchange Fund. 3
113	57
114		-	(c) The ~~[Pilot] Program required under this section shall be designed~~ to: 11
	58	+	(b) (1) The purpose of the Fund is to: 4
115	59
116		-	(1) ~~reduce~~ the ~~amount that young adults pay for health benefit plans in~~ the 12
117		-	~~individual health insurance market~~; ~~and 13~~
	60	+	(i) provide funding for the operation and administration of the 5
	61	+	Exchange in carrying out the purposes of the Exchange under this subtitle; 6
118	62
119		-	(2) ~~target young adults who are not directly impacted by~~ the State 14
120		-	Reinsurance Program~~. 15~~
	63	+	(ii) provide funding for the establishment and operation of the State 7
	64	+	Reinsurance Program authorized under this subtitle; 8
121	65
122		-	(d) (1) [For calendar years 2022 through 2025] FOR EACH CALENDAR YEAR , 16
123		-	the Exchange, in consultation with the Commissioner and as approved by the Board, shall 17
124		-	establish subsidy eligibility and payment parameters for the [Pilot] Program. 18
	66	+	(iii) provide funding for the Medical Assistance Program and the 9
	67	+	Senior Prescription Drug Assistance Program; 10
125	68
126		-	(2) In determining the subsidy eligibility and payment parameters 19
127		-	required under paragraph (1) of this subsection, the Exchange shall consider: 20
	69	+	(iv) provide funding for the establishment and operation of Health 11
	70	+	Equity Resource Communities under Title 20, Subtitle 14 of the Health – General Article; 12
	71	+	and 13
128	72
129		-	(i) young adults at least 18 years old and under the age of 41 years; 21
130		-	and 22
	73	+	(v) provide funding for the establishment and operation of the 14
	74	+	State–Based Young Adult Health Insurance Subsidies [Pilot] Program authorized under 15
	75	+	this subtitle. 16
131	76
132		-	(ii) income groups between 133% and 400% of the federal poverty 23
133		-	level. 24
	77	+	(2) The operation and administration of the Exchange, the State 17
	78	+	Reinsurance Program, the State–Based Young Adult Health Insurance Subsidies [Pilot] 18
	79	+	Program, and the Qualified Resident Enrollment Program may include functions delegated 19
	80	+	by the Exchange to a third party under law or by contract. 20
134	81
135		-	(e) (1) Subject to available funds and paragraph (2) of this subsection, in each 25
136		-	[of] fiscal [years 2022 through 2026] YEAR, the Exchange may designate funds from the 26
137		-	Fund to be used for the [Pilot] Program so that annual subsidies may be provided to young 27
138		-	adults who meet the subsidy eligibility and payment parameters established under 28
139		-	subsection (d) of this section. 29
	82	+	(f) (1) The Fund may be used only: 21
140	83
141		-	(2) (I) For each of calendar years 2024 and 2025, the funds designated 30
142		-	under paragraph (1) of this subsection may not exceed $20,000,000 plus any unspent funds 31
143		-	designated for subsidies for young adults in a previous calendar year. 32
144		-	4 SENATE BILL 5
	84	+	(iv) for the establishment and operation of the State–Based Young 22
	85	+	Adult Health Insurance Subsidies [Pilot] Program. 23
	86	+
	87	+	(g) (1) The Board shall maintain separate accounts within the Fund for 24
	88	+	Exchange operations, for the State Reinsurance Program, and for the State–Based Young 25
	89	+	Adult Health Insurance Subsidies [Pilot] Program. 26
	90	+
	91	+	31–122. 27
	92	+
	93	+	(a) In this section, [“Pilot Program”] “PROGRAM” means the State–Based Young 28
	94	+	Adult Health Insurance Subsidies [Pilot] Program. 29
	95	+	SENATE BILL 5 3
145	96
146	97
147		-	(II) ~~FOR CALENDAR YEAR 2026 AND EACH CALENDAR YE AR~~ 1
148		-	~~THEREAFTER , THE~~ EXCHANGE, IN CONSULTATION WITH THE COMMISSIONER , ~~MAY~~ 2
149		-	~~DESIGNATE FUNDS FROM THE FUND TO PROVIDE ANNUA L~~ SUBSIDIES ~~TO YOUNG~~ 3
150		-	ADULTS ~~WHO MEET~~ THE ~~SUBSIDY ELIGIBILITY AND PAYMENT PARAMETE RS~~ 4
151		-	~~ESTABLISHED UNDER SU BSECTION (D) OF THIS SECTION~~. 5
	98	+	(b) (1) [The] SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , THE 1
	99	+	Exchange, in consultation with the Commissioner and as approved by the Board, [shall] 2
	100	+	MAY establish and implement a State–Based Young Adult Health Insurance Subsidies 3
	101	+	[Pilot] Program to provide subsidies to young adults for the purchase of health benefit plans 4
	102	+	in the individual health insurance market. 5
152	103
153		-	(f) The Exchange shall adopt regulations implementing the provisions of this 6
154		-	section. 7
	104	+	(2) THE EXCHANGE MAY NOT IMPL EMENT THE PROGRAM FOR 6
	105	+	CALENDAR YEARS IN WH ICH FUNDS FROM THE DISTRIBUTIO N OF THE ASSESSMENT 7
	106	+	UNDER § 6–102.1 OF THIS ARTICLE ARE NOT AVAILABLE . 8
155	107
156		-	(g) The Exchange shall adopt regulations to provide a subsidy to cover 100% of 8
157		-	the cost of the premium for young adults who have a 0% expected contribution under the 9
158		-	subsidy eligibility parameters established under subsection (d) of this section. 10
	108	+	(c) The [Pilot] Program required under this section shall be designed to: 9
159	109
160		-	~~(h)~~ (1) The ~~Exchange shall track on a monthly basis expenditures on subsidies 11~~
161		-	~~provided under the [Pilot] Program,~~ ~~including: 12~~
	110	+	(1) reduce the amount that young adults pay for health benefit plans in the 10
	111	+	individual health insurance market; and 11
162	112
163		-	(i) ~~the average number of~~ young adults ~~receiving subsidies under 13~~
164		-	~~the [Pilot]~~ Program~~; and 14~~
	113	+	(2) target young adults who are not directly impacted by the State 12
	114	+	Reinsurance Program. 13
165	115
166		-	(ii) the average subsidy amount received by young adults under the 15
167		-	[Pilot] Program. 16
	116	+	(d) (1) [For calendar years 2022 through 2025] FOR EACH CALENDAR YEAR , 14
	117	+	the Exchange, in consultation with the Commissioner and as approved by the Board, shall 15
	118	+	establish subsidy eligibility and payment parameters for the [Pilot] Program. 16
168	119
169		-	(2) The Exchange shall track: 17
	120	+	(2) In determining the subsidy eligibility and payment parameters 17
	121	+	required under paragraph (1) of this subsection, the Exchange shall consider: 18
170	122
171		-	(i) ~~the impact~~ the ~~[Pilot] Program has on rates in the individual 18~~
172		-	~~insurance market;~~ and 19
	123	+	(i) young adults at least 18 years old and under the age of 41 years; 19
	124	+	and 20
173	125
174		-	(ii) ~~the impact of covering 100~~% of the ~~cost of premiums for qualified 20~~
175		-	~~participants on effectuation rates and termination for nonpayment rates~~. 21
	126	+	(ii) income groups between 133% and 400% of the federal poverty 21
	127	+	level. 22
176	128
177		-	(3) The information tracked by the Exchange under paragraphs (1) and (2) 22
178		-	of this subsection shall be: 23
	129	+	(e) (1) Subject to available funds and paragraph (2) of this subsection, in each 23
	130	+	[of] fiscal [years 2022 through 2026] YEAR, the Exchange may designate funds from the 24
	131	+	Fund to be used for the [Pilot] Program so that annual subsidies may be provided to young 25
	132	+	adults who meet the subsidy eligibility and payment parameters established under 26
	133	+	subsection (d) of this section. 27
179	134
180		-	(i) posted on the website of the Exchange; and 24
	135	+	(2) (I) For each of calendar years 2024 and 2025, the funds designated 28
	136	+	under paragraph (1) of this subsection may not exceed $20,000,000 plus any unspent funds 29
	137	+	designated for subsidies for young adults in a previous calendar year. 30
181	138
182		-	(ii) included in the annual report required under § 31–119(d) of this 25
183		-	subtitle. 26
	139	+	(II) FOR CALENDAR YEAR 2026 AND EACH CALENDAR YE AR 31
	140	+	THEREAFTER , THE EXCHANGE, IN CONSULTATION WITH THE COMMISSIONER , MAY 32
	141	+	DESIGNATE FUNDS FROM THE FUND TO PROVIDE ANNUA L SUBSIDIES TO YOUNG 33 4 SENATE BILL 5
184	142
185		-	Chapter 778 of the Acts of 2021, as amended by Chapters 256 and 257 of the Acts 27
186		-	of 2023 28
187	143
188		-	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 29
189		-	1, 2021. [It shall remain effective for a period of 5 years and, at the end of June 30, 2026, 30
190		-	this Act, with no further action required by the General Assembly, shall be abrogated and 31
191		-	of no further force and effect.] 32
	144	+	ADULTS WHO MEET THE SUBSIDY ELIGIBILITY AND PAYMENT PARAMETE RS 1
	145	+	ESTABLISHED UNDER SU BSECTION (D) OF THIS SECTION. 2
	146	+
	147	+	(f) The Exchange shall adopt regulations implementing the provisions of this 3
	148	+	section. 4
	149	+
	150	+	(g) The Exchange shall adopt regulations to provide a subsidy to cover 100% of 5
	151	+	the cost of the premium for young adults who have a 0% expected contribution under the 6
	152	+	subsidy eligibility parameters established under subsection (d) of this section. 7
	153	+
	154	+	(h) (1) The Exchange shall track on a monthly basis expenditures on subsidies 8
	155	+	provided under the [Pilot] Program, including: 9
	156	+
	157	+	(i) the average number of young adults receiving subsidies under 10
	158	+	the [Pilot] Program; and 11
	159	+
	160	+	(ii) the average subsidy amount received by young adults under the 12
	161	+	[Pilot] Program. 13
	162	+
	163	+	(2) The Exchange shall track: 14
	164	+
	165	+	(i) the impact the [Pilot] Program has on rates in the individual 15
	166	+	insurance market; and 16
	167	+
	168	+	(ii) the impact of covering 100% of the cost of premiums for qualified 17
	169	+	participants on effectuation rates and termination for nonpayment rates. 18
	170	+
	171	+	(3) The information tracked by the Exchange under paragraphs (1) and (2) 19
	172	+	of this subsection shall be: 20
	173	+
	174	+	(i) posted on the website of the Exchange; and 21
	175	+
	176	+	(ii) included in the annual report required under § 31–119(d) of this 22
	177	+	subtitle. 23
	178	+
	179	+	Chapter 778 of the Acts of 2021, as amended by Chapters 256 and 257 of the Acts 24
	180	+	of 2023 25
	181	+
	182	+	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 26
	183	+	1, 2021. [It shall remain effective for a period of 5 years and, at the end of June 30, 2026, 27
	184	+	this Act, with no further action required by the General Assembly, shall be abrogated and 28
	185	+	of no further force and effect.] 29
	186	+
	187	+	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 30
	188	+	1, 2025. 31
192	189		SENATE BILL 5 5
193	190
194	191
195		-	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 1
196		-	1, 2025. 2
197	192
198		-
199		-
200		-
201		-	Approved:
202		-	________________________________________________________________________________
203		-	Governor.
204		-	________________________________________________________________________________
205		-	President of the Senate.
206		-	________________________________________________________________________________
207		-	Speaker of the House of Delegates.